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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)
- 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.
Details
- Language :
- English
- ISSN :
- 16626575
- Volume :
- 12
- Issue :
- 2
- Database :
- Directory of Open Access Journals
- Journal :
- Case Reports in Oncology
- Publication Type :
- Academic Journal
- Accession number :
- edsdoj.b912564c36a40df80d6ca712b0e4b6b
- Document Type :
- article
- Full Text :
- https://doi.org/10.1159/000501548