Analysis of local recurrence pattern for limited stage small cell lung cancer after IMRT plus chemotherapy

Objective To investigate localized regional recurrence after chemotherapy and chest radiotherapy in limited stage small cell lung cancer (LS-SCLC), and explore the relationship between recurrence location and radiotherapy and chemotherapy and its influencing factors. Methods From 2006 to 2014, pathological LS-SCLC treated in CAMS, 125 patients had local recurrence, Kaplan-Meier statistical method was used to analyze the survival rate and PFS of each recurrence site. Log-rank was used to compare the survival rate of each group. Univariate analysis includes Chi-squareand t-test for the factors for the recurrence site. Multivariate analysis using Logistic regression. Results The 1-, 2-and 5-year overall survival rates were 92.0%, 46.4% and 14.7%, respectively. The median progression time was 12.96 months, The median survival time after progression was 11.5 months, and the 1-, 2-, and 5-year overall survival rates were 45.0%, 23.0%, and 10.0%, respectively. The recurrence sites include intrapulmonary recurrence (67 patients), regional lymph nodes (21 patients), simultaneous intrapulmonary and regional lymph nodes (28 patients), and contralateral or supraclavicular lymph nodes (9 patients). The median survival time were 23.96 months, 24.76 months, 23.23 months, and 18.66 months, and the 2-year survival rates were 49%, 52%, 46%, and11%, respectively (P=0.000, 0.004, 0.008). In 6 patients (4.0%), 5 patients were located in the supraclavicular region, and 1 patient (0.8%) in the field. Conclusions For LS-SCLC undergoing IMRT and chemotherapy, the local failure location is mainly located in the pulmonary, and further treatment of the split dose and targets requires further clinical exploration. Key words: Lung neoplasms/radiochemoradiation; Radiotherapy, intensity-modulated; Patterns of failure