Impact of the Radiation Dose on Survival after Radiochemotherapy for Small-cell Lung Cancer

Aim: Radiochemotherapy for small-cell lung cancer may not be sufficiently tolerated by all patients. To contribute to better personalization of the radiochemotherapy programs, this study compared two radiotherapy doses and 10 characteristics for survival. Patients and Methods: In 71 patients receiving radiochemotherapy for small-cell lung cancer, the radiation dose given as equivalent dose in 2 Gy fractions (EQD2: <56 vs. >= 56 Gy) plus 10 characteristics, namely gender, age, Karnofsky performance score, T-category, N-category, tumor stage, pack years, smoking during radiotherapy, respiratory insufficiency and hemoglobin prior to radiotherapy, were evaluated for survival. Results: On multivariate analysis, EQD2 >= 56 Gy (p=0.003), female gender (p=0.029), Karnofsky performance score >70 (p<0.001), very limited disease (p=0.043) and pre-radiotherapy hemoglobin >= 12 g/dl (p=0.044) were significantly associated with better survival. Conclusion: This study identified several independent predictors of survival after radiochemotherapy of small-cell lung cancer. A radiation dose of >= 56 Gy resulted in better survival than lower doses.