Hypofractionated Concomitant Chemoradiation in Inoperable Locally Advanced Non-small Cell Lung Cancer: A Report on 100 Patients and a Systematic Review

Iqbal, Muhammad Shahid; Vashisht, G.; McMenemin, R.; Atherton, Philip J.; McDonald, Fiona; Simmons, T.; Bradshaw, Alexander; Kovařík, Josef; Turnbull, H.; Dodd, Leslie G.; Mulvenna, P.; Greystoke, Alastair

doi:10.1016/j.clon.2018.10.006

Cited by 19 publications

(12 citation statements)

References 20 publications

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“…Our findings validate a smaller series that reported a median survival of 43 months in patients treated with the SOCCAR regimen [ 6 ] and support the use of moderately hypofractionated radiotherapy with concomitant chemotherapy in patients with stage III NSCLC.…”

supporting

confidence: 88%

Hypofractionated Accelerated Concurrent Chemoradiotherapy in Inoperable Stage III Non-small Cell Lung Cancer: SOCCAR. A Large Single-Centre Experience

et al. 2020

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supporting

confidence: 88%

Hypofractionated Accelerated Concurrent Chemoradiotherapy in Inoperable Stage III Non-small Cell Lung Cancer: SOCCAR. A Large Single-Centre Experience

et al. 2020

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“…Following the study, a number of the participating centres adopted the schedule, fine-tuning chemotherapy regimens and evolving treatment techniques by applying positron emission tomography-computed tomography staging, four-dimensional planning, IMRT and volumetric modulated arc radiotherapy (VMAT). With these adaptions, UK centres are reporting encouraging 58% 2-year survival and acceptable rates of acute toxicity [23], which compares favourably with more recent trials, e.g. PACIFIC [24].…”

Section: Evidencementioning

confidence: 66%

Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent Radiotherapy during the COVID-19 Pandemic

et al. 2020

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Patients treated with curative-intent lung radiotherapy are in the group at highest risk of severe complications and death from COVID-19. There is therefore an urgent need to reduce the risks associated with multiple hospital visits and their anti-cancer treatment. One recommendation is to consider alternative dosefractionation schedules or radiotherapy techniques. This would also increase radiotherapy service capacity for operable patients with stage I-III lung cancer, who might be unable to have surgery during the pandemic.Here we identify reduced-fractionation for curative-intent radiotherapy regimes in lung cancer, from a literature search carried out between 20/03/2020 and 30/ 03/2020 as well as published and unpublished audits of hypofractionated regimes from UK centres. Evidence, practical considerations and limitations are discussed for early-stage NSCLC, stage III NSCLC, early-stage and locally advanced SCLC. We recommend discussion of this guidance document with other specialist lung MDT members to disseminate the potential changes to radiotherapy practices that could be made to reduce pressure on other departments such as thoracic surgery. It is also a crucial part of the consent process to ensure that the risks and benefits of undergoing cancer treatment during the COVID-19 pandemic and the uncertainties surrounding toxicity from reduced fractionation have been adequately discussed with patients. Furthermore, centres should

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“…68 Alternative fractionations could include 55 Gy in 20 fractions with reasonable toxicity profiles. [69][70] Sequential chemotherapy followed by radiotherapy could be considered but would expose patients to a prolonged course of cancer treatment during an ongoing pandemic. As discussed previously, SARS-CoV-2 infection may induce radiologic abnormalities similar to radiationinduced pneumonitis or immunotherapy induced pneumonitis.…”

Section: Overall Treatment Of Patients With Lung Cancermentioning

confidence: 99%

Treatment Guidance for Patients With Lung Cancer During the Coronavirus 2019 Pandemic

Dingemans

Soo

Jazieh

et al. 2020

Journal of Thoracic Oncology

106

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The global coronavirus disease 2019 pandemic continues to escalate at a rapid pace inundating medical facilities and creating substantial challenges globally. The risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with cancer seems to be higher, especially as they are more likely to present with an immunocompromised condition, either from cancer itself or from the treatments they receive. A major consideration in the delivery of cancer care during the pandemic is to balance the risk of patient exposure and infection with the need to provide effective cancer treatment. Many aspects of the SARS-CoV-2 infection currently remain poorly characterized and even less is known about the course of infection in the context of a patient with cancer. As SARS-CoV-2 is highly contagious, the risk of infection directly affects the cancer patient being treated, other cancer patients in close proximity, and health care providers. Infection at any level for patients or providers can cause considerable disruption to even the most effective treatment plans. Lung cancer patients, especially those with reduced lung function and cardiopulmonary comorbidities are more likely to have increased risk and mortality from coronavirus disease 2019 as one of its common manifestations is as an acute respiratory illness. The purpose of this manuscript is to present a practical multidisciplinary and international overview to assist in treatment for lung cancer patients during this pandemic, with the caveat that evidence is lacking in many areas. It is expected that firmer recommendations can be developed as more evidence becomes available.

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Hypofractionated Concomitant Chemoradiation in Inoperable Locally Advanced Non-small Cell Lung Cancer: A Report on 100 Patients and a Systematic Review

Cited by 19 publications

References 20 publications

Hypofractionated Accelerated Concurrent Chemoradiotherapy in Inoperable Stage III Non-small Cell Lung Cancer: SOCCAR. A Large Single-Centre Experience

Hypofractionated Accelerated Concurrent Chemoradiotherapy in Inoperable Stage III Non-small Cell Lung Cancer: SOCCAR. A Large Single-Centre Experience

Reduced Fractionation in Lung Cancer Patients Treated with Curative-intent Radiotherapy during the COVID-19 Pandemic

Treatment Guidance for Patients With Lung Cancer During the Coronavirus 2019 Pandemic

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