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Clinical features and treatment outcomes of resected large cell neuroendocrine carcinoma of the lung

Authors
 Jin Young Moon  ;  Seo Hee Choi  ;  Tae Hyung Kim  ;  Joongyo Lee  ;  Ji Hoon Pyo  ;  Yong Tae Kim  ;  Seo Jin Lee  ;  Hong In Yoon  ;  Jaeho Cho  ;  Chang Geol Lee 
Citation
 RADIATION ONCOLOGY JOURNAL, Vol.39(4) : 288-296, 2021-12 
Journal Title
RADIATION ONCOLOGY JOURNAL
ISSN
 2234-1900 
Issue Date
2021-12
Keywords
Cranial irradiation ; Lung neoplasms ; Neuroendocrine tumors ; Prognosis ; Small cell lung carcinoma
Abstract
Purpose: Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a high-grade lung neuroendocrine tumor with a poor prognosis, similar to small cell lung cancer (SCLC). However, it remains unclear whether to treat LCNEC as non-small-cell lung cancer (NSCLC) or as SCLC. We reviewed our experiences to suggest appropriate treatment strategy for resected pulmonary LCNEC.

Materials and methods: Forty-four patients were treated for pathologically diagnosed pulmonary LCNEC during 2005‒2018. We considered curative surgery first in early-stage or some locally advanced tumors, unless medically inoperable. Adjuvant treatments were decided considering patient's clinical and pathological features. After excluding two stage I tumors with radiotherapy alone and three stage III tumors with upfront chemotherapy, we analyzed 39 patients with stage I‒III pulmonary LCNEC, who underwent curative resection first.

Results: Adjuvant chemotherapy (NSCLC-based 91%, SCLC-based 9%) was performed in 62%, and adjuvant radiotherapy was done in three patients for pN2 or positive margin. None received prophylactic cranial irradiation (PCI). With a median follow-up of 30 months, the 2- and 5-year overall survival (OS) rates were 68% and 51%, and the 2- and 5-year recurrence-free survival (RFS) rates were 49% and 43%, respectively. Aged ≥67 years and SCLC-mixed pathology were significant poor prognostic factors for OS or RFS (p < 0.05). Among 17 recurrences, regional failures were most common (n = 6), and there were five brain metastases.

Conclusions: Surgery and adjuvant treatment (without PCI) could achieve favorable outcomes in pulmonary LCNEC, which was more similar to NSCLC, although some factors worsened the prognosis. The importance of intensified adjuvant therapies with multidisciplinary approach remains high.
Files in This Item:
T202125521.pdf Download
DOI
10.3857/roj.2021.00423
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Taehyung(김태형)
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Lee, Joongyo(이준교)
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Jae Ho(조재호) ORCID logo https://orcid.org/0000-0001-9966-5157
Choi, Seo Hee(최서희) ORCID logo https://orcid.org/0000-0002-4083-6414
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188071
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