Long-term survivors of small-cell lung cancer (SCLC): A French multicenter study
Identifieur interne : 001D19 ( Main/Exploration ); précédent : 001D18; suivant : 001D20Long-term survivors of small-cell lung cancer (SCLC): A French multicenter study
Auteurs : P. Jacoulet ; A. Depierre [France] ; D. Moro [France] ; A. Rivière ; B. Milleron ; E. Quoix [France] ; E. Ranfaing ; D. Anthoine ; J. J. Lafitte ; B. Lebeau ; J. P. Kleisbauer ; F. Massin ; P. Fournel ; M. Zaegel ; J. P. Leclerc ; G. Garnier ; E. Brambilla ; F. CapronSource :
- Annals of Oncology [ 0923-7534 ] ; 1997-10.
Abstract
Background The aim of this study was to analyze SCLC patients beyond 30 months, particularly their outcome, their way of life, and factors which could influence relapses, second-primary cancers and death. Patients and methods Between January 1986 and May 1995, 263 SCLC patients who survived longer than 30 months were included from 52 French institutions. The analysis was performed on the 155 cases confirmed by a pathologic review. Results Physical, mental and psychological states were considered as normal at 30 months in respectively 70.3%, 87.7% and 67.7% of patients, not influenced by prophylactic cranial irradiation, number of chemotherapy cycles, CCNU or cisplatin. Therapeutic sequelae were neurological impairment (13%), pulmonary fibrosis (18%) and cardiac disorders (11%) at 30 months. Return to work was possible for 40% of patients in the first two years following diagnosis. Among 43 relapsing patients, 33 benefited from a second-line treatment. Their median survival was 12 months since retreatment, and seven patients have survived again longer than 30 months. Age > 60 at the time of diagnosis was found as an independent factor increasing the risk of relapse beyond 30 months (OR = 2.46, IC 95% (1.16–5.26), P = 0.01). The risk of relapse became less than 10% beyond five years. Twenty patients (13%) developed a second primary cancer in a mean time of 58.6 months. The risk of second primary cancer was increased by a number of chemotherapy cycles > 6 (OR = 3.25, IC 95% (1.08–9.8) P = 0.02) and by an age > 60 (OR = 2.92, IC 95% (1.07–7.97), P = 0.03). Five- and 10-year survival rates were respectively 68% and 44%. In these patients having reached a 30-month survival, three independent factors were predictive of a survival longer than five years: age ≤60 at the time of diagnosis (OR = 2.85, IC 95% (1.23–6.6), P = 0.01), chest radiotherapy (OR = 3.1, IC 95% (1.28–7.69), P – 0.006) and absence of relapse (OR = 4.5, IC 95% (1.75–12.5), P – 0.002). This study suggests that: 1) therapeutic sequelae are rather mild, allowing return to work in 40% of patients; 2) relapsing 30-month survivors can benefit from second-line treatment; 3) SCLC cure can be achieved with a 10-year follow-up.
Url:
DOI: 10.1023/A:1008287922285
Affiliations:
- France
- Alsace (région administrative), Auvergne-Rhône-Alpes, Grand Est, Rhône-Alpes
- Grenoble, Strasbourg
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Jacoulet</name></author><author><name sortKey="Depierre, A" sort="Depierre, A" uniqKey="Depierre A" first="A." last="Depierre">A. Depierre</name><affiliation></affiliation><affiliation wicri:level="1"><country xml:lang="fr">France</country><wicri:regionArea>Correspondence to: A. Depierre</wicri:regionArea></affiliation></author><author><name sortKey="Moro, D" sort="Moro, D" uniqKey="Moro D" first="D." last="Moro">D. Moro</name><affiliation wicri:level="3"><country>France</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName></affiliation></author><author><name sortKey="Riviere, A" sort="Riviere, A" uniqKey="Riviere A" first="A." last="Rivière">A. Rivière</name><affiliation><wicri:noCountry code="no comma">Caen</wicri:noCountry></affiliation></author><author><name sortKey="Milleron, B" sort="Milleron, B" uniqKey="Milleron B" first="B." last="Milleron">B. Milleron</name><affiliation><wicri:noCountry code="no comma">Paris Tenon</wicri:noCountry></affiliation></author><author><name sortKey="Quoix, E" sort="Quoix, E" uniqKey="Quoix E" first="E." last="Quoix">E. Quoix</name><affiliation wicri:level="3"><country>France</country><placeName><settlement type="city">Strasbourg</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region></placeName></affiliation></author><author><name sortKey="Ranfaing, E" sort="Ranfaing, E" uniqKey="Ranfaing E" first="E." last="Ranfaing">E. Ranfaing</name></author><author><name sortKey="Anthoine, D" sort="Anthoine, D" uniqKey="Anthoine D" first="D." last="Anthoine">D. Anthoine</name></author><author><name sortKey="Lafitte, J J" sort="Lafitte, J J" uniqKey="Lafitte J" first="J. J." last="Lafitte">J. J. Lafitte</name><affiliation><wicri:noCountry code="no comma">Lille</wicri:noCountry></affiliation></author><author><name sortKey="Lebeau, B" sort="Lebeau, B" uniqKey="Lebeau B" first="B." last="Lebeau">B. Lebeau</name><affiliation><wicri:noCountry code="no comma">Paris Saint Antoine</wicri:noCountry></affiliation></author><author><name sortKey="Kleisbauer, J P" sort="Kleisbauer, J P" uniqKey="Kleisbauer J" first="J. P." last="Kleisbauer">J. P. Kleisbauer</name><affiliation><wicri:noCountry code="no comma">Marseille Sainte Marguerite</wicri:noCountry></affiliation></author><author><name sortKey="Massin, F" sort="Massin, F" uniqKey="Massin F" first="F." last="Massin">F. Massin</name></author><author><name sortKey="Fournel, P" sort="Fournel, P" uniqKey="Fournel P" first="P." last="Fournel">P. Fournel</name><affiliation><wicri:noCountry code="no comma">Saint Etienne</wicri:noCountry></affiliation></author><author><name sortKey="Zaegel, M" sort="Zaegel, M" uniqKey="Zaegel M" first="M." last="Zaegel">M. Zaegel</name><affiliation><wicri:noCountry code="no comma">Chartres</wicri:noCountry></affiliation></author><author><name sortKey="Leclerc, J P" sort="Leclerc, J P" uniqKey="Leclerc J" first="J. P." last="Leclerc">J. P. Leclerc</name></author><author><name sortKey="Garnier, G" sort="Garnier, G" uniqKey="Garnier G" first="G." last="Garnier">G. Garnier</name></author><author><name sortKey="Brambilla, E" sort="Brambilla, E" uniqKey="Brambilla E" first="E." last="Brambilla">E. Brambilla</name></author><author><name sortKey="Capron, F" sort="Capron, F" uniqKey="Capron F" first="F." last="Capron">F. Capron</name></author></analytic><monogr></monogr><series><title level="j">Annals of Oncology</title><idno type="ISSN">0923-7534</idno><idno type="eISSN">1569-8041</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="1997-10">1997-10</date><biblScope unit="volume">8</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1009">1009</biblScope><biblScope unit="page" to="1014">1014</biblScope></imprint><idno type="ISSN">0923-7534</idno></series><idno type="istex">10D5AC71BF62A07014A4F479B8A877871F94F6D2</idno><idno type="DOI">10.1023/A:1008287922285</idno><idno type="ArticleID">8.10.1009</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0923-7534</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background The aim of this study was to analyze SCLC patients beyond 30 months, particularly their outcome, their way of life, and factors which could influence relapses, second-primary cancers and death. Patients and methods Between January 1986 and May 1995, 263 SCLC patients who survived longer than 30 months were included from 52 French institutions. The analysis was performed on the 155 cases confirmed by a pathologic review. Results Physical, mental and psychological states were considered as normal at 30 months in respectively 70.3%, 87.7% and 67.7% of patients, not influenced by prophylactic cranial irradiation, number of chemotherapy cycles, CCNU or cisplatin. Therapeutic sequelae were neurological impairment (13%), pulmonary fibrosis (18%) and cardiac disorders (11%) at 30 months. Return to work was possible for 40% of patients in the first two years following diagnosis. Among 43 relapsing patients, 33 benefited from a second-line treatment. Their median survival was 12 months since retreatment, and seven patients have survived again longer than 30 months. Age > 60 at the time of diagnosis was found as an independent factor increasing the risk of relapse beyond 30 months (OR = 2.46, IC 95% (1.16–5.26), P = 0.01). The risk of relapse became less than 10% beyond five years. Twenty patients (13%) developed a second primary cancer in a mean time of 58.6 months. The risk of second primary cancer was increased by a number of chemotherapy cycles > 6 (OR = 3.25, IC 95% (1.08–9.8) P = 0.02) and by an age > 60 (OR = 2.92, IC 95% (1.07–7.97), P = 0.03). Five- and 10-year survival rates were respectively 68% and 44%. In these patients having reached a 30-month survival, three independent factors were predictive of a survival longer than five years: age ≤60 at the time of diagnosis (OR = 2.85, IC 95% (1.23–6.6), P = 0.01), chest radiotherapy (OR = 3.1, IC 95% (1.28–7.69), P – 0.006) and absence of relapse (OR = 4.5, IC 95% (1.75–12.5), P – 0.002). This study suggests that: 1) therapeutic sequelae are rather mild, allowing return to work in 40% of patients; 2) relapsing 30-month survivors can benefit from second-line treatment; 3) SCLC cure can be achieved with a 10-year follow-up.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Alsace (région administrative)</li><li>Auvergne-Rhône-Alpes</li><li>Grand Est</li><li>Rhône-Alpes</li></region><settlement><li>Grenoble</li><li>Strasbourg</li></settlement></list><tree><noCountry><name sortKey="Anthoine, D" sort="Anthoine, D" uniqKey="Anthoine D" first="D." last="Anthoine">D. Anthoine</name><name sortKey="Brambilla, E" sort="Brambilla, E" uniqKey="Brambilla E" first="E." last="Brambilla">E. Brambilla</name><name sortKey="Capron, F" sort="Capron, F" uniqKey="Capron F" first="F." last="Capron">F. Capron</name><name sortKey="Fournel, P" sort="Fournel, P" uniqKey="Fournel P" first="P." last="Fournel">P. Fournel</name><name sortKey="Garnier, G" sort="Garnier, G" uniqKey="Garnier G" first="G." last="Garnier">G. Garnier</name><name sortKey="Jacoulet, P" sort="Jacoulet, P" uniqKey="Jacoulet P" first="P." last="Jacoulet">P. Jacoulet</name><name sortKey="Kleisbauer, J P" sort="Kleisbauer, J P" uniqKey="Kleisbauer J" first="J. P." last="Kleisbauer">J. P. Kleisbauer</name><name sortKey="Lafitte, J J" sort="Lafitte, J J" uniqKey="Lafitte J" first="J. J." last="Lafitte">J. J. Lafitte</name><name sortKey="Lebeau, B" sort="Lebeau, B" uniqKey="Lebeau B" first="B." last="Lebeau">B. Lebeau</name><name sortKey="Leclerc, J P" sort="Leclerc, J P" uniqKey="Leclerc J" first="J. P." last="Leclerc">J. P. Leclerc</name><name sortKey="Massin, F" sort="Massin, F" uniqKey="Massin F" first="F." last="Massin">F. Massin</name><name sortKey="Milleron, B" sort="Milleron, B" uniqKey="Milleron B" first="B." last="Milleron">B. Milleron</name><name sortKey="Ranfaing, E" sort="Ranfaing, E" uniqKey="Ranfaing E" first="E." last="Ranfaing">E. Ranfaing</name><name sortKey="Riviere, A" sort="Riviere, A" uniqKey="Riviere A" first="A." last="Rivière">A. Rivière</name><name sortKey="Zaegel, M" sort="Zaegel, M" uniqKey="Zaegel M" first="M." last="Zaegel">M. Zaegel</name></noCountry><country name="France"><noRegion><name sortKey="Depierre, A" sort="Depierre, A" uniqKey="Depierre A" first="A." last="Depierre">A. Depierre</name></noRegion><name sortKey="Moro, D" sort="Moro, D" uniqKey="Moro D" first="D." last="Moro">D. Moro</name><name sortKey="Quoix, E" sort="Quoix, E" uniqKey="Quoix E" first="E." last="Quoix">E. Quoix</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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