Clinical Manifestation and Survival of Patients with Small-Cell Lung Cancer
Kreetha Thammakumpee MD*, Siwasak Juthong MD*, Vilaiwan Viriyachaiyo MD*, Warangkana Rittirak MD*, Wiwatana Tanomkiat MD**
Affiliation : * Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla ** Department of Radiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla
Objective : To assess the clinical manifestation, diagnostic investigation, treatment, and survival of patients
with small-cell lung cancer (SCLC).
Design : Retrospective study.
Materials and Methods : Patients with histologically and/or cytologically proven SCLC, adequate medical
record for clinical history, and survival between January 1, 1999 and December 31, 2003, were reviewed. The
stage of disease at presentation was based on the Veterans’ Administration Lung Cancer Study Group (VALSG)
staging system of limited-stage and extensive-stage disease.
Results : One hundred and sixteen evaluative SCLC patients were enrolled in the present study. SCLC was
common in elderly men who smoked. Major symptoms were cough 81%, weight loss 72%, and dyspnea 67%.
Hoarseness and superior vena cava syndrome (SVC syndrome) were present in 18% and 17% respectively.
Forty-nine patients (42%) presented with limited-stage disease and 67 (58%) with extensive-stage disease.
Thirty patients (26%) received chemotherapy alone, 23 patients (20%) received radiotherapy alone, 33
patients (28%) received combined chemoradiotherapy, and 30 patients (26%) received supportive treatment.
A chemotherapy regimen of cisplatin combined with etoposide was used in 61 of 63 patients (97%). The
overall response to chemotherapy was complete remission in 12 cases (19%), and partial response in 20 cases
(32%). The median survival of limited-stage disease was significantly better than those with extensive-stage
disease (44 weeks vs. 22 weeks). Patients with chemotherapy treatment had significantly improved median
survival in both limited-stage and extensive-stage disease.
Conclusion : More than half of the SCLC patients presented in extensive-stage disease. The majority of the
patients were treated with systemic chemotherapy. Patients with limited-stage disease had better response to
chemotherapy and better survival than those with extensive-stage disease.
Keywords : Small-cell lung cancer, Treatment, Prognosis
