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© 2019 Kubicek GJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ORIGINAL ARTICLE | OPEN ACCESSDOI: 10.23937/2378-3419/1410111

Importance of Time to Chemotherapy Initiation in Small Cell Lung Cancer

Gregory J Kubicek1*, Rachel Koehler2, Matthew J Rossi2, Christian Squillante3, Alexander Hageboutros3, Melvin Pratter4, Stephen Akers4 and Polina Khrizman3

1MD Anderson-Cooper Cancer Center, Radiation Oncology Camden NJ, USA

2Cooper Medical School, Rowan University, Camden NJ, USA

3MD Anderson-Cooper Cancer Center, Medical Oncology Camden NJ, USA

4MD Anderson-Cooper Cancer Center, Pulmonary Medicine, Camden NJ, USA



Small cell lung cancer (SCLC) is an aggressive malignancy with a short median survival time. Because of the rapid growth rate there may be an advantage to emergently beginning chemotherapy as soon as SCLC diagnosis is made.


All SCLC patients evaluated at Cooper University Hospital from January 2011 to September 2014 were reviewed. Multiple clinical factors were analyzed including timing between diagnosis and start of chemotherapy.


A total of 75 patients were analyzed. On univariate analysis there was a survival detriment to early initiation of chemotherapy. With multivariate analysis the difference in survival disappeared. With logistic regression, the only variable that was related to overall survival was stage (extensive versus limited). We did not find any subset that benefited from early initiation of chemotherapy.


Mortality and cumulative survival time were not improved by early initiation of chemotherapy for any patient subset. Only stage at diagnosis was predictive for mortality and cumulative survival. Our data appears to show that urgency in starting chemotherapy has little bearing on survival in patients diagnosed with SCLC. The data suggest that there is no detriment to a non-urgent start time for chemotherapy.