Treatment Outcomes of Primary Pulmonary Lymphoepithelioma-like Carcinoma: a Series of 22 Patients and Treatment Strategy Review

Full Article

FST Mok, OSH Chan, ATY Chang, LLK Chan, IS Soong, WT Ng, FY Cheung, RMW Yeung

Hong Kong J Radiol 2013;16:270-7

DOI: 10.12809/hkjr1313176

Objectives: Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare subgroup of non–small-cell lung cancer. Limited published series suggested that it might be associated with more favourable survival than ordinary non–small-cell lung cancer. We set out to review the treatment outcomes of patients with primary pulmonary LELC treated in our institution since 1994.

Methods: All patients with pathologically confirmed primary pulmonary LELC treated between 1994 and 2012 were retrospectively reviewed. Treatment modalities and outcomes — including local control rate, disease-free and overall survival — were analysed.

Results: Twenty-two patients with primary pulmonary LELC were identified. Their median follow-up duration was 33 months (range, 1 day to 106 months). Surgery was the mainstay of treatment for patients with stage I to II diseases. Those with advanced non-metastatic disease (n = 5) treated with high-dose radiotherapy (EQD2 60 Gy) with or without platinum-based chemotherapy had a local control rate of 100% after a median follow-up of 68 months. The 5-year progression-free survival (PFS) and overall survival (OS) were 53% and 80%, respectively. Their median PFS and OS had not reached at the time of publication. For patients with stages III and IV disease beyond radical radiotherapy portals, palliative platinum doublets gave a median disease-free survival of 10 months in 12 patients. The 5-year OS of stage I-II, III, and IV patients were 41%, 38%, and 25%, respectively (p = 0.61). Their median OS durations were 58, 30, and 19 months, respectively.

Conclusion: Our series echoed prior suggestions that primary pulmonary LELC achieves favourable outcomes.







結果:發現原發性肺LELC22例。病例的隨訪期中位數為33個月(範圍:1日至106個月)。對於第I至第II期的患者來說,手術是主要的治療方法。於中位隨訪期68個月後,接受高劑量放療(EQD2為60 Gy)的晚期無轉移瘤患者(n = 5)局部控制率達100%;伴或不伴以鉑類藥物為基礎的化療均如此。五年無進展生存率(PFS)和總體生存率(OS)分別為53%和80%。至本文發表時,尚未獲得PFS和OS的中位數數據。至於無法施以根治性放療第III及第IV期患者,有12例因接受含鉑類雙藥聯合方案的姑息性化療而無瘤中位生存期達至10個月。第I-II、III和IV期的五年OS分別為41%、38%和25%(p = 0.61),其中位生存期分別為58、30和19個月。