Phase 2 Study of Accelerated Hypofractionated Thoracic Radiation Therapy and Concurrent Chemotherapy in Patients With Limited-Stage Small-Cell Lung Cancer

Xia, Bing; Hong, Lingzhi; Cai, Xu-Wei; Zhu, Zhengfei; Liu, Qi; Zhao, Kuaile; Fan, Min; Mao, Jingfang; Yang, Heqing; Wu, Keyi; Fu, Xiaolong

doi:10.1016/j.ijrobp.2014.09.042

Cited by 32 publications

(27 citation statements)

References 29 publications

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“…The cumulative incidences of 2-year survival and PFS were 57.3% vs. 62.2% ( p = 0.698) and 33.5% vs. 32.4% ( p = 0.991), respectively, for the ConvTRT and HypoTRT cohorts. The survival data of HypoTRT cohort was close to those reported by Xia et al in the phase II trial [15]. In univariate analysis, early TRT defined as beginning with 1–3 cycle of chemotherapy was not prognostic factor for either PFS or OS.…”

Section: Discussionsupporting

confidence: 81%

“…Nevertheless, the efficacy of HypoTRT in patients with LS-SCLC remained unsolved. In a phase II study from our institution, Xia et al [15] reported a favorable median 2-year progression free survival of 49% and overall survival of 58.2% in 59 LS-SCLC patients treated with concurrent HypoTRT (55 Gy/22 F) and etoposide/cisplatin. However, earlier data from Cleveland Clinic [17] revealed that changing from a HypoTRT (40 Gy/15 F) to a ConvTRT (50 Gy/25 F) prescription did not alter survival or toxicity outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Murray et al [14] reported a favorable efficacy of HypoTRT (40 Gy/15 F) early in 1993, during the era of two-dimensional radiotherapy, with a median OS and 5-year survival rate of 21.2 months and 22%, respectively. An ensuing phase II study of HypoTRT 55 Gy (2.5 Gy per fraction) and concurrent chemotherapy achieved a median OS of 28.5 months and a 2-year survival rate of 58.2% [15]. LS-SCLC patients in our institution were treated with once-daily TRT (either ConvTRT or HypoTRT) combined with chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Hypo- or conventionally fractionated radiotherapy combined with chemotherapy in patients with limited stage small cell lung cancer

et al. 2017

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BackgroundPrevious data from our institution showed that hypofractionated thoracic radiotherapy (HypoTRT) with concurrent etoposide/platinum chemotherapy yielded favorable survival in patients with limited-stage small cell lung cancer (LS-SCLC). The present study retrospectively compared the survival outcomes, failure patterns and toxicities between groups of LS-SCLC patients treated with conventionally fractionated thoracic radiotherapy (ConvTRT) or HypoTRT combined with chemotherapy.MethodsMedical records of LS-SCLC patients between January 2010 and December 2013 at Fudan University Shanghai Cancer Center were retrospectively reviewed. All patients treated with chemotherapy and ConvTRT (2 Gy per fraction daily, DT ≥ 56 Gy) or HypoTRT (2.5 Gy per fraction daily, DT = 55 Gy) were eligible for analysis. Progression-free survival (PFS) and overall survival (OS) were generated for different populations using the Kaplan-Meier method and compared using the log-rank test. Comparisons of failure patterns and toxicity were analyzed using the χ 2 test.ResultsA total of 170 patients treated with HypoTRT (n = 69) or ConvTRT (n = 101) were eligible for analysis. The median PFS and OS were 13.7 and 25.3 months, respectively, in the ConvTRT cohort, which was similar to the HypoTRT cohort (PFS 18.2 months, p = 0.991, and OS 27.2 months, p = 0.698), with a median follow-up of 30 months. Multivariate analysis revealed that PCI and TNM stage were prognostic factors for PFS and that PCI was prognostic for OS. The patterns of failure (stratified by local-regional recurrence, distant metastasis or both as first relapse) were similar between the dose cohorts (p = 0.693, p = 0.330, p = 0.572). Distant metastasis remained the main failure pattern. The brain was the most frequent remote failure site, followed by bone, liver and adrenal gland. PCI improved the 2-year survival rate from 46.1% to 70.0% and the 2-year PFS rate from 20.9% to 45.3%, respectively (p < 0.001). Grade ≥3 esophagitis and pneumonitis occurred in 9.9% and 11.9%, respectively, of the patients in the ConvTRT cohort and in 11.6% and 10.0%, respectively, of those in the HypoTRT cohort (p = 0.815).ConclusionThis retrospective analysis demonstrated that HypoTRT or ConvTRT combined with etoposide/platinum chemotherapy yielded statistically similar survival, treatment failure outcomes, and toxicity profiles. PCI correlated with improved PFS and OS.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hypo- or conventionally fractionated radiotherapy combined with chemotherapy in patients with limited stage small cell lung cancer

et al. 2017

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“…Although we chose IMRT as the photon modality with which a dosimetric comparison was made, the use of IMRT has been underreported for SCLC. Data show promise for the reduction of toxicities with IMRT, especially for high‐volume disease . Nevertheless, 3‐dimensional conformal RT remains a commonly used modality for SCLC .…”

Section: Discussionmentioning

confidence: 99%

Prospective study of proton‐beam radiation therapy for limited‐stage small cell lung cancer

Rwigema

Verma

Lin

et al. 2017

Cancer

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“…Since the publication of INT 0096, many groups have investigated different radiation dose regimens for LS-SCLC with concurrent chemotherapy [14] (Tables 3 and 4). These studies show a range of 2 year OS from 32-64% [3,[11][12][13][14][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]. INT 0096 demonstrated 47% OS at 2 years with twice daily treatment compared to 41% with once daily regime [14].…”

Section: Discussionmentioning

confidence: 99%

Once Daily High-dose Radiation (≥60 Gy) Treatment in Limited Stage Small Cell Lung Cancer

et al. 2017

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Phase 2 Study of Accelerated Hypofractionated Thoracic Radiation Therapy and Concurrent Chemotherapy in Patients With Limited-Stage Small-Cell Lung Cancer

Cited by 32 publications

References 29 publications

Hypo- or conventionally fractionated radiotherapy combined with chemotherapy in patients with limited stage small cell lung cancer

Hypo- or conventionally fractionated radiotherapy combined with chemotherapy in patients with limited stage small cell lung cancer

Prospective study of proton‐beam radiation therapy for limited‐stage small cell lung cancer

Once Daily High-dose Radiation (≥60 Gy) Treatment in Limited Stage Small Cell Lung Cancer

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