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Small-Cell Lung Cancer Treatment of Newly Diagnosed Patients with Poor Performance Status
- Source :
- Case Reports in Oncology, Vol 12, Iss 2, Pp 613-620 (2019), Case Reports in Oncology
- Publication Year :
- 2019
- Publisher :
- Karger Publishers, 2019.
-
Abstract
- Small-cell lung cancer (SCLC) is highly sensitive to platinum-based chemotherapy. However, its indication in patients with a poor performance status (PS) at initial diagnosis is controversial. We retrospectively reviewed all clinical courses of pathologically diagnosed SCLC patients with poor PS, Eastern Cooperative Oncology Group PS 3 and 4. Among 18 patients, 12 were treated with chemotherapy and 6 with supportive care alone. During the chemotherapy courses, PS improved in 7 (58.3%, including the PS 4 cases), remained stable in 2 (16.7%), and deteriorated in 3 (25%) patients. Moreover, 5 patients showed partial responses to chemotherapy (response rate of 41.7%). Grade 3-4 neutropenia developed in 10 (83.3%) patients and grade 3 febrile neutropenia occurred in 5 (41.7%) patients, but no grade 4 non-hematological toxicity was noted. Mortality associated with lung toxicity (grade 5) due to treatment occurred in a 77-year-old-male patient with PS 3. No substantial difference in survival was observed between patients with PS 3 and 4, even when including those treated with supportive care alone. Treatment had a positive effect on survival: after chemotherapy, the 6-month survival rate of PS 3 and 4 patients was 66.7%. In contrast, all patients treated with supportive care alone died within 5 months. These findings suggest that chemotherapy is indicated in selected SCLC patients not only with PS 3, but also with PS 4. (C) 2019 The Author(s) Published by S. Karger AG, Basel
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
medicine.medical_treatment
Case Report
Neutropenia
Gastroenterology
lcsh:RC254-282
Small-cell lung cancer
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Chemotherapy
Poor performance status
Lung cancer
Survival rate
Platinum
Response rate (survey)
business.industry
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
030104 developmental biology
Oncology
030220 oncology & carcinogenesis
Toxicity
business
Febrile neutropenia
Supportive care
Subjects
Details
- Language :
- English
- ISSN :
- 16626575
- Volume :
- 12
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Case Reports in Oncology
- Accession number :
- edsair.doi.dedup.....4287c4a6a4e32841f24685fadd078f72