YAYGIN EVRE KÜÇÜK HÜCRELİ AKCİĞER KANSERİNDE KONSOLİDATİF TORAKAL RADYOTERAPİNİN YERİ

Yıl 2016, Cilt: 30 Sayı: 1, 1 - 6, 01.05.2016

Esra Korkmaz Kıraklı Berna Kömürcüoğlu

Öz

Amaç: Bu çalışmada yaygın evre küçük hücreli akciğer kanserli (KHAK), sisplatin bazlı kemoterapi (KT) ile metastazlarında tam yanıt ve primer lezyonda tam ya da kısmi yanıt veren olgularda konsolidasyon torasik radyoterapi (TRT)'nin lokal kontrol, hastalıksız ve total sağkalıma etkisinin araştırılması amaçlanmıştır. Gereç ve Yöntem: Ocak 2012-Haziran 2015 tarihleri retrospektif olarak incelendi. Olgular içinden KT sonrası metastatik lezyonlarda tam yanıt alınan ve konsolidasyon amaçlı TRT alan olgular değerlendirmeye alındı. Yineleme paternleri incelendi. Progresyonsuz sağkalım ve total sağkalım analizleri yapıldı. Bulgular: Merkezimizde KHAK tanısıyla RT gören 486 olgunun 10'u çalışmaya dahil edildi. ECOG performans durumu 8 olguda 0-1, 2 olguda 2'ydi. Lokal kontrol %60, progresyonsuz sağkalım 5 ay, total sağkalım medyan 12.5 ay, 1 yıllık sağkalım %60, 2 yıllık sağkalım %10 olarak saptandı. Sonuç: KT'ye yanıt veren yaygın evre KHAK'li olgularda, konsolidasyon TRT'si lokal kontrole ve sağkalıma katkı sağlayabilir.

Anahtar Kelimeler

Yaygın evre, küçük hücreli akciğer kanseri, torakal radyoterapi

ROLE OF THORACIC RADIOTHERAPY IN EXTENSIVE STAGE SMALL CELL LUNG CANCER

Öz

Aim: This study aimed to evaluate the effect of consolidative thoracic radiotherapy on local control and progression free and overall survival in extensive stage small cell lung cancer patients whose metastatic lesions responded totally and primary lesions totally or partially to cisplatin based chemotherapy. Materials and Methods: Medical records of patients diagnosed as extensive stage small cell lung cancer between January 2012 and June 2015 were evaluated retrospectively. Patients whose metastatic lesions fully responded to chemotherapy and underwent consolidative thoracic radiotherapy were included. Relapse patterns were evaluated and progression free and overall survival were analyzed. Results: 10 of the 486 patients with SCLC who underwent radiotherapy were included. ECOG performance satus was 0-1 in 8 patients and was 2 in 2 patients. Local control was 60%, progression free survival was 5 months and overall survival was 12.5 months. One year survival rate was 60% and two years survival rate was 10%. Conclusion: Consolidative thoracic radiotherapy may improve local control and survival in extensive stage small cell cancer patients who responded to chemotherapy.

Anahtar Kelimeler

Extensive stage, small cell lung cancer, thoracic radiotherapy

Kaynakça

• 1. National Comprehensive Cancer Network. Clinical practice guidelines. Small cell lung cancer. Available at:. May 5, 2015]; Available from: http://www.nccn.org/professionals/ physician_gls/pdf/ sclc.pdf.
• 2. NRG Oncology. RTOG 0937. Available from: http://www.rtog.org/ClinicalTrials/ProtocolTable/ StudyDetails. aspx?study=0937.
• 3. Palma D.A., Warner A, Louie AV, Senan S, Slotman B, Rodrigues GB. Thoracic Radiotherapy for Extensive Stage Small-Cell Lung Cancer: A Meta-Analysis. Clin Lung Cancer 2015 Oct 1. pii: S1525-7304(15)00239-9. doi: 10.1016/j.cllc.2015.09.007.
• 4. Slotman B.J, Tinteren HV, Praag JO, Knegjens JL, El Sharouni SY, Hatton M, Keijser , Faivre- Finn C, Senan S. Use of thoracic radiotherapy for extensive stage small-cell lung cancer: a phase 3 randomised controlled trial. Lancet 2015; 385: 36-42.
• 5. Slotman B.J, Tinteren HV. Which patients with extensive stage small-cell lung cancer should and should not receive thoracic radiotherapy? Transl Lung Cancer Res 2015; 4(3): 292-4.
• 6. Common Terminology Criteria for Adverse Events (CTCAE), Version 4.0. 2010; Available from: http://evs.nci.nih.gov/ftp1/CTCAE/About.html.
• 7. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45(2): 228- 47.
• 8. Yee D, Butts C, Reiman A, Joy A, Smylie M, Fenton D, Chu Q, Hanson J, Roa W. Clinical trial of post-chemotherapy consolidation thoracic radiotherapy for extensive-stage small cell lung cancer. Radiother Oncol 2012; 102(2): 234-8.
• 9. Giuliani ME, Atallah S, Sun A, Bezjak A, Le LW, Brade A, Cho J, Leighl NB, Shepherd FA, Hope AJ. Clinical outcomes of extensive stage small cell lung carcinoma patients treated with consolidative thoracic radiotherapy. Clin Lung Cancer 2011; 12(6): 375-9.
• 10. Singer L, Yom SS. Consolidative radiation therapy for extensive-stage small cell lung cancer. Transl Lung Cancer Res 2015; 4(3): 211-4.
• 11. Jeremic B, Shibamoto Y, Nikolic N, Milicic B, Milisavljevic S, Dagovic A, Aleksandrovic J, Radosavljevic-Asic G. Role of radiation therapy in the combined-modality treatment of patients with extensive disease small-cell lung cancer: A randomized study. J Clin Oncol 1999; 17(7): 2092-9.
• 12. Zhu H, Zhou Z, Wang Y, Bi N, Feng Q, Li J, Lv J, Chen D, Shi Y, Wang L. Thoracic radiation therapy improves the overall survival of patients with extensive-stage small cell lung cancer with distant metastasis. Cancer 2011; 117(23): 5423-31.