Service of Neumology, University Hospital Complex of Vigo, Vigo, Spain.
Department of Medical Oncology, Hospital HM La Esperanza, Santiago de Compostela, Spain.
ESMO Open. 2021 Apr;6(2):100059. doi: 10.1016/j.esmoop.2021.100059. Epub 2021 Feb 26.
Lung cancer is a public health problem worldwide. Small-cell lung cancer (SCLC) is the most aggressive histologic type, with a 5-year survival <10%. SCLC is closely associated with tobacco consumption and infrequent in never-smokers. We aim to describe SCLC characteristics in never-smokers recruited in a radon-prone area.
We designed a multicentric case series where SCLC cases were recruited consecutively following histologic confirmation. Detailed information was obtained for indoor radon exposure, occupation and environmental tobacco smoke. We also collected different clinical characteristics such as extended or limited disease at diagnosis.
We recruited 32 never-smoking SCLC cases. Median age was 75 years and 87.5% were women; 47% had extended disease. Median radon concentration was 182 Bq/m. There were no statistically significant differences in residential radon concentration neither regarding age at diagnosis nor regarding sex. The most frequent symptoms were constitutional syndrome (23.1%) and coughing (23.1%). As much as 63% of cases had an Eastern Cooperative Oncology Group Study (ECOG) status of 0-2. The 1- and 2-year survival rates were 34.4% and 21.9%, respectively. The 2-year survival rate with a localized tumor was 26.7%, compared with 18.8% for extended disease.
These results show, for the first time, that indoor radon might not be associated with SCLC characteristics at diagnosis in never-smokers, and also confirms the low survival of this aggressive type of lung cancer also for never-smokers.
肺癌是全球范围内的一个公共卫生问题。小细胞肺癌（SCLC）是最具侵袭性的组织学类型，5 年生存率<10%。SCLC 与烟草消费密切相关，在从不吸烟者中很少见。我们旨在描述在氡高发地区招募的从不吸烟者中的 SCLC 特征。
我们设计了一项多中心病例系列研究，其中 SCLC 病例是在组织学确认后连续招募的。详细信息包括室内氡暴露、职业和环境烟草烟雾。我们还收集了不同的临床特征，如诊断时的广泛或局限疾病。
我们招募了 32 例从不吸烟的 SCLC 患者。中位年龄为 75 岁，87.5%为女性；47%为广泛疾病。中位氡浓度为 182 Bq/m。诊断时的年龄和性别与住宅氡浓度均无统计学差异。最常见的症状是全身综合征（23.1%）和咳嗽（23.1%）。多达 63%的病例 ECOG 状态为 0-2。1 年和 2 年生存率分别为 34.4%和 21.9%。局限性肿瘤的 2 年生存率为 26.7%，而广泛疾病的生存率为 18.8%。
这些结果首次表明，室内氡可能与从不吸烟者的 SCLC 特征无关，也证实了这种侵袭性肺癌在从不吸烟者中的低生存率。
