Randomized comparison of early versus late hyperfractionated thoracic irradiation concurrently with chemotherapy in limited disease small-cell lung cancer: A randomized phase II study of the Hellenic Cooperative Oncology Group (HeCOG)

Abstract

Concurrent administration of HTRT with carboplatin etoposide is associated with a high response and survival rate. Although a trend for higher response rate was recorded in the group of patients who received late HTRT, the overall median, 2-year and 3-year survival rates did not differ significantly between the two treatment groups. The toxicity of this promising therapeutic approach was acceptable. Comparative phase III studies with an adequate number of patients are recommended in order to answer this question.

Phase II trial of irinotecan and cisplatin with early concurrent radiotherapy in limited‐disease small‐cell lung cancer

“…[1][2][3][4][5] In spite of the good response of tumors to chemoradiation, most patients still die as a result of systemic metastasis, with a median survival of 17-27 months and a 2-year survival rate of 33% to 54%. [4][5][6][7] Therefore, more effective systemic chemotherapy regimens are needed to improve patient outcomes for LD-SCLC.…”

A Review of Current Radiation Therapies for the Treatment of Metastatic Brain Tumors

“…NCCN guidelines still support its use [7,8,23,24]. However, due to the associated neurodegeneration, there is a trend to only treat the brain with radiation, if lesions are detected [23].…”

“…NCCN guidelines still support its use [7,8,23,24]. However, due to the associated neurodegeneration, there is a trend to only treat the brain with radiation, if lesions are detected [23]. The original rationale for prophylactic cranial irradiation (PCI) in limited small cell cancer that was advocated by Hansen in 1973 is that CNS relapse in small cell lung cancer is analogous to isolated CNS relapse in Acute lymphoblastic leukemia (ALL) [7].…”

Management of small cell carcinoma of the bladder: Consensus guidelines from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

“…81 In the case of SCLC, some of the commonly used doses/schedules of chemotherapy in combined chemoradiation are: cisplatin 60 mg/m 2 D1 and etoposide 120 mg/m 2 D1-3, 82 cisplatin 80 mg/m 2 D1 and etoposide 100 mg/m 2 D1-3, 83 carboplatin AUC 5-6 D1 and etoposide 100mg/m 2 D1-3. 84,85 In a recent meta-analysis of individual patient data in SCLC, carboplatin was demonstrated to be equivalent to cisplatin for patients treated with chemotherapy alone or chemoradiation, but with different toxicity profile. 86 Carboplatin was associated with more myelosuppression and cisplatin had more nephrotoxicity, neurotoxicity and nausea/emesis.…”