Is there a place for optimizing thoracic radiotherapy in limited-stage small cell lung cancer after twenty years?

查看全文 作　　者：Jose Maximo [1]Barros;Manglio Miguel [2]Rizzo;Jorge Oscar [1]Chiozza;Felipe [3]Counago

机构地区：[1]Department of Radiation Oncology,Radiotherapy Center,Hospital Universitario Austral,Vidt Oncologia Radiante,CABA 1425,Argentina;[2]Department of Medical Oncology,Hospital Universitario Austral,Buenos Aires 1629,Argentina;[3]Department of Radiation Oncology,Hospital Universitario Quirónsalud Madrid,Hospital La Luz,Universidad Europea de Madrid,Madrid 28028,Spain

出　　处：《World Journal of Clinical Oncology》索引2021年第12卷第1期,共5页

摘　　要：Thoracic radiotherapy(TRT)is one of the main treatments in limited-stage small cell lung cancer(LS-SCLC).Hyperfractionated TRT(45 Gy,1.5 Gy twice daily)has been the standard of care(SOC)since Turrisi and colleagues published the results of their clinical trial in 1999.Two meta-analyses have demonstrated the benefits of concurrent chemotherapy and TRT in terms of intrathoracic disease control at 2 years and 3-year overall survival(OS).The phase 2 trial by Grønberg et al(2016)comparing once-daily hypofractionated TRT to twice-daily hyperfractionated TRT in LS-SCLC found similar outcomes in both groups in terms of response rate,progression-free survival(PFS),grade 3-4 adverse effects,and OS.The CONVERT trial,published in 2017,failed to demonstrate the superiority of the conventional scheme(once-daily TRT)vs twice-daily radiotherapy,despite the application of modern radiotherapy techniques and a quality assurance programme,thus confirming the twice-daily hyperfractionated regimen as the SOC.At the 2020 American Society of Clinical Oncology(ASCO)annual meeting,Grønberg et al reported preliminary findings from a phase 2 trial comparing two different TRT dose regimens(45 Gy vs 60 Gy),both administered twice daily.Those data demonstrated a marked improvement in 2-year survival rates in the high dose arm(70.2%vs 46.1%,P=0.002),despite similar objective response rates and PFS outcomes.Those findings provide a new treatment alternative to consider:Hyperfractionated,high-dose TRT.However,the results of that trial will need to be validated in a large,randomized phase 3 study.The results of the phase 2 CALCG 30610 trial will help to clarify the optimal dose and regimen.The potential role of upfront immunotherapy,which early data suggest may improve OS,also needs to be determined. 关键词：Thoracic radiotherapy Limited-stage small cell lung cancer Hyperfractionated High dose American Society of Clinical Oncology Small cell lung cancer

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Is there a place for optimizing thoracic radiotherapy in limited-stage small cell lung cancer after twenty years?

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