Karnosky Performance Score and Radiation Dose Predict Survival of Patients Re-irradiated for a Locoregional Recurrence of Small Cell Lung Cancer

AIM: When patients with small cell lung cancer (SCLC) experience locoregional recurrence, surgery is often not employed as salvage therapy. Systemic chemotherapy and radiotherapy are often used. Many radiation oncologists are reluctant to deliver a second course of radiotherapy. However, select patients may benefit from re-irradiation. This study aimed to identify these patients.

PATIENTS AND METHODS: In patients receiving re-irradiation for a locoregional recurrence of SCLC, 11 potential prognostic factors were analyzed for survival.

RESULTS: Survival was positively associated with a Karnofsky performance score ≥80 (p=0.003) and a cumulative dose >90 Gy (p=0.026). A trend was observed for younger age, longer interval between first course of radiotherapy and re-irradiation, a greater dose of re-irradiation and for concurrent chemotherapy.

CONCLUSION: Significant predictors of survival in patients re-irradiated for a locoregional recurrence of SCLC were identified. Patients with a good performance status can benefit from re-irradiation if administered in sufficient doses.