TURKISH JOURNAL OF ONCOLOGY 2022 , Vol 37 , Num 4
Survival Outcomes in Limited-stage Small Cell Lung Cancer Treated with Chemoradiotherapy
Ela DELİKGÖZ SOYKUT1,Eylem ODABAŞI1,Evrim ŞAVLI1,Zehra ER2,Ahmet BARAN2,Esra ARSLAN AKSU3,Alaettin ARSLAN4
1Department of Radiation Oncology, University of Health Sciences, Samsun Training and Research Hospital, Samsun-Türkiye
2Department of Medical Oncology, University of Health Sciences, Samsun Training and Research Hospital, Samsun-Türkiye
3Department of Pulmonary Medicine, University of Health Sciences, Samsun Training and Research Hospital, Samsun-Türkiye
4Department of Radiation Oncology, University of Health Sciences, Kayseri Training and Research Hospital, Kayseri-Türkiye
DOI : 10.5505/tjo.2022.3586 OBJECTIVE
The aim of this study is to examine the survival outcomes in limited-stage small-cell lung cancer (SCLC) treated with definitive chemoradiotherapy and to evaluate the prognostic factors that may affect survival.

METHODS
83 patients diagnosed with limited-stage SCLC were identified retrospectively. Demographic features, clinical information, hemoglobin level, lactate dehydrogenase, C-reactive protein, and albumin levels were recorded. Kaplan?Meier method was used to calculate overall survival (OS), progression-free survival (PFS), and local regional recurrence-free survival (LRRFS), and differences were assessed using the Log-rank test. The Cox proportional hazard regression model was performed to evaluate the potential prognostic variables.

RESULTS
Thoracic radiotherapy was given with 1st or 2nd chemotherapy in 68.7% of the patients. Prophylactic cranial irradiation (PCI) was applied to 45.9% of the patients. At a median follow-up of 14 (3?83) months, 5 of the patients were alive at the final follow-up. Disease recurrence was observed in 31 patients, distant metastases were detected in 51 patients. Median and 2-y OS, PFS and LRRFS were 16, 11, and 14 months and 31.8%, 20.5%, and 26.9%, respectively. Hypoalbuminemia was found to affect PFS and LRRFS in univariate analysis (p=0.033, p=0.044). In subgroup analysis, PCI was effective on OS (p=0.045). In multivariate regression analysis, no significant relationship was found between PCI and OS (p=0.055), hypoalbuminemia was statistically significant on PFS and LRRFS (p=0.022, p=0.032).

CONCLUSION
With the addition of PCI to the treatment, there was a tendency to improve in terms of OS. Low albumin level at the time of diagnosis was found to negatively affect PFS and LRRFS. Keywords : Chemoradiotherapy; hypoalbuminemia; prognosis; prophylactic cranial irradiation; small-cell lung cancer; survival