Role of surgery and subsequent need for RT in treatment of stage I SCLC

Findings identify an effective alternative to traditional treatment methods

Research published in February's edition of the Journal of Thoracic Oncology investigates the utilization of surgery and the subsequent need for radiotherapy (RT) when treating stage I small cell lung cancer (SCLC). Traditionally, SCLC treatment regimes include chemotherapy and radiotherapy for limited stage disease; however, the study concludes that in selected patients with early stage disease a lobectomy (removal of lung) had an excellent overall survival without additional treatment.

Researchers retrospectively evaluated the outcomes of 247 stage I SCLC patients who underwent lobectomies; these cases were identified using the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) database. Results showed the three- and five-year survival rates for the patient group who underwent lobectomies without RT were 58.1 percent and 50.3 percent, respectively. For those who supplemented their surgery with RT, three- and five -year overall survival was 64.9 percent and 57.1 percent.

"Based on our analysis, surgery without RT may offer a reasonable survival in a selected cohort of patients who undergo lobectomy, but this needs to be validated in a prospective setting," said study lead investigator James B. Yu, MD, of Yale University. "We cannot say conclusively whether patients who endure invasive surgeries can go without additional adjuvant radiation or chemotherapy, but looking forward, the study findings create a platform for advancing the understanding of the role of surgery in therapy."