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Outcome and prognostic factors of multimodal therapy for pulmonary large-cell neuroendocrine carcinomas

Rieber, Juliane ; Schmitt, Julian ; Warth, Arne ; Muley, Thomas ; Kappes, Jutta ; Eichhorn, Florian ; Hoffmann, Hans ; Heussel, Claus Peter ; Welzel, Thomas ; Debus, Jürgen ; Thomas, Michael ; Steins, Martin ; Rieken, Stefan

In: European journal of medical research: official organ "Deutsche AIDS-Gesellschaft", 20 (2015), Nr. 64. pp. 1-8. ISSN 2047-783X

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Download (1MB) | Lizenz: Creative Commons LizenzvertragOutcome and prognostic factors of multimodal therapy for pulmonary large-cell neuroendocrine carcinomas by Rieber, Juliane ; Schmitt, Julian ; Warth, Arne ; Muley, Thomas ; Kappes, Jutta ; Eichhorn, Florian ; Hoffmann, Hans ; Heussel, Claus Peter ; Welzel, Thomas ; Debus, Jürgen ; Thomas, Michael ; Steins, Martin ; Rieken, Stefan underlies the terms of Creative Commons Attribution 3.0 Germany

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Abstract

Background: There is controversy whether patients diagnosed with large-cell neuroendocrine carcinoma (LCNEC) should be treated according to protocols for non-small cell lung cancers (NSCLC) or small cell lung cancers (SCLC), especially with regard to the administration of prophylactic cranial irradiation (PCI). This study was set up to determine the incidence of brain metastases and to investigate the outcome following multimodal treatment in 70 patients with LCNEC. Methods: Seventy patients with histologically confirmed LCNEC were treated at the University Hospital of Heidelberg between 2001 and 2014. Data were collected retrospectively. Al most all patients received thoracic surgery as initial treatment (94 %). Chemotherapy was administered in 32 patients as part of the initial treatment. Fourteen patients were treated with adjuvant or definitive thoracic radiotherapy according to NSCLC protocols. Cranial radiotherapy due to brain metastases, mostly given as whole brain radiotherapy (WBRT), was received by fourteen patients. Statistical analysis was performed using the long-rank test and the Kaplan–Meier method. Results: Without PCI, the detected rate for brain metastases was 25 % after a median follow-up time of 23.4 months, which is comparable to NSCLC patients in general. Overall (OS), local (LPFS), brain metastases-free survival (BMFS) and extracranial distant progression-free survival (eDPFS) was 43, 50, 63 and 50 % at 5 years, respectively. Patients with incomplete resection showed a survival benefit from adjuvant radiotherapy. The administration of adjuvant chemotherapy improved the general worse prognosis in higher pathologic stages. Conclusion: In LCNEC patients, the administration of radiotherapy according to NSCLC guidelines appears reasonable and contributes to acceptable results of multimodal treatment regimes. The low incidence of spontaneous brain metastases questions a possible role of PCI.

Item Type: Article
Journal or Publication Title: European journal of medical research: official organ "Deutsche AIDS-Gesellschaft"
Volume: 20
Number: 64
Publisher: BioMed Central
Place of Publication: London
Date Deposited: 25 Nov 2015 14:41
Date: 2015
ISSN: 2047-783X
Page Range: pp. 1-8
Faculties / Institutes: Medizinische Fakultät Heidelberg > Radiologische Universitätsklinik
Medizinische Fakultät Heidelberg > Pathologisches Institut
Medizinische Fakultät Heidelberg > Thoraxklinik Heidelberg gGmbH
Subjects: 610 Medical sciences Medicine
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