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Shorter Duration of Treatment Improves Survival with Small-C

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Cancer News Article

Shorter Duration of Treatment Improves Survival with Small-Cell Lung Cancer

Researchers from Belgium have reported that a shorter treatment interval is associated with an improved survival of patients with limited-disease small-cell lung cancer (SCLC). The details of this report were published in the March 1, 2006, issue of the Journal of Clinical Oncology.

The treatment of SCLC is a combination of platinum-based chemotherapy and radiation therapy. However, the sequence of administration of these two approaches is still being investigated. A factor that may influence the success of treatment is the overall duration of treatment. Both normal cells and surviving tumor cells can proliferate in between doses of chemotherapy or radiation therapy, and the rate of this re-growth may increase over the course of treatment. For patients with quickly growing cancers, it may be possible to improve survival by maximizing the number of treatment doses given before rapid re-growth of cells begins. This approach, however, is likely to cause more adverse effects of treatment.

To explore whether duration of treatment influences survival with limited-disease SCLC, researchers conducted a combined analysis of four clinical trials. These trials enrolled a total of 1,056 patients. Treatment in all four trials involved platinum-based chemotherapy and radiation therapy. Duration of treatment was defined as the start of any treatment to the end of radiation therapy.

Shorter duration of treatment was linked with significantly improved survival. Compared to the shortest duration evaluated, each one-week extension in duration of treatment reduced five-year survival by roughly 2%.

Patients with shorter duration of treatment were also more likely to experience severe esophagitis (inflammation of the esophagus).

The researchers conclude that shorter duration from the start of chemotherapy to the end of radiation therapy appears to be linked with better survival in patients with limited-disease SCLC.

Comments: These data are consistent with other studies such as comparing dose-dense chemotherapy given every 2 weeks with chemotherapy given every 3-4 weeks.

Reference: De Ruysscher D, Pijls-Johannesma M, Bentzen SM et al. Time Between the First Day of Chemotherapy and the Last Day of Chest Radiation is the Most Important Predictor of Survival in Limited-Disease Small Cell Lung Cancer. Journal of Clinical Oncology . 2006;24:1057-1063.

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