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Duration of Chemotherapy for Small Cell Lung Cancer: A Meta-Analysis

Author

Listed:
  • Hang Zhou
  • Chao Zeng
  • Yang Wei
  • Jin Zhou
  • Wenxiu Yao

Abstract

Background: Maintenance chemotherapy is widely provided to patients with small cell lung cancer (SCLC). However, the benefits of maintenance chemotherapy compared with observation are a subject of debate. Methodology and Principal Findings: To identify relevant literature, we systematically searched the Medline, Embase, and Cochrane Central Register of Controlled Trials databases. Eligible trials included patients with SCLC who either received maintenance chemotherapy (administered according to a continuous or switch strategy) or underwent observation. The primary outcome was 1-year mortality, and secondary outcomes were 2-year mortality, overall survival (OS), and progression-free survival (PFS). Of the 665 studies found in our search, we identified 14 relevant trials, which together reported data on 1806 patients with SCLC. When compared with observation, maintenance chemotherapy had no effect on 1-year mortality (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.66–1.19; P = 0.414), 2-year mortality (OR: 0.82; 95% CI: 0.57–1.19; P = 0.302), OS (hazard ratio [HR]: 0.87; 95% CI: 0.71–1.06; P = 0.172), or PFS (HR: 0.87; 95% CI: 0.62–1.22; P = 0.432). However, subgroup analyses indicated that maintenance chemotherapy was associated with significantly longer PFS than observation in patients with extensive SCLC (HR, 0.72; 95% CI: 0.58–0.89; P = 0.003). Additionally, patients who were managed using the continuous strategy of maintenance chemotherapy appeared to be at a disadvantage in terms of PFS compared with patients who only underwent observation (HR, 1.27; 95% CI: 1.04–1.54; P = 0.018). Conclusions/Significance: Maintenance chemotherapy failed to improve survival outcomes in patients with SCLC. However, a significant advantage in terms of PFS was observed for maintenance chemotherapy in patients with extensive disease. Additionally, our results suggest that the continuous strategy is inferior to observation; its clinical value needs to be investigated in additional trials.

Suggested Citation

  • Hang Zhou & Chao Zeng & Yang Wei & Jin Zhou & Wenxiu Yao, 2013. "Duration of Chemotherapy for Small Cell Lung Cancer: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-9, August.
    • Handle: RePEc:plo:pone00:0073805
    DOI: 10.1371/journal.pone.0073805
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Lin Wang & Chuanhao Tang & Bin Xu & Lin Yang & Lili Qu & Liangliang Li & Xiaoyan Li & Weixia Wang & Haifeng Qin & Hongjun Gao & Kun He & Xiaoqing Liu, 2017. "Mass spectrometry-based serum peptidome profiling accurately and reliably predicts outcomes of pemetrexed plus platinum chemotherapy in patients with advanced lung adenocarcinoma," PLOS ONE, Public Library of Science, vol. 12(6), pages 1-15, June.
    2. Mantang Qiu & Xin Yang & Jingwen Hu & Xiangxiang Ding & Feng Jiang & Rong Yin & Lin Xu, 2013. "Predictive Value of XPD Polymorphisms on Platinum-Based Chemotherapy in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-8, August.
    3. Xiao-yong Shen & Fan-zhen Lu & Yun Wu & Li-ting Zhao & Zhi-feng Lin, 2013. "XRCC3 Thr241Met Polymorphism and Clinical Outcomes of NSCLC Patients Receiving Platinum-Based Chemotherapy: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-7, August.

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