Stereotactic Body Radiotherapy (SBRT) in Very Limited-Stage Small Cell Lung Cancer (VLS-SCLC)

Abstract

Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumour with metastatic propensity. Stereotactic body radiation therapy (SBRT) is an emerging therapeutic option for SCLC, despite limited supporting evidence. By evaluating the use of SBRT in very limited stage (VLS) SCLC at our institution, we aimed to contribute to the existing knowledge in this area while establishing a basis for further research. We performed a retrospective review of all cases of VLS-SCLC treated with SBRT between 2013 and 2020. Baseline demographics, diagnostic, and treatment information were collected. The primary outcome was overall survival (OS). We identified 46 patients with pathologically confirmed VLS-SCLC; 25 were treated with SBRT, and the remainder received either surgery, conventional radiation therapy, chemotherapy, or palliative-intent therapy. After a median follow-up of 23.7 months, 44% of the patients had died; the median OS was of 24.4 months for the SBRT cohort and 67.0 months for the curative intent non-SBRT cohort. The difference in disease recurrence and survival between cohorts was underpowered and not statistically significant. Higher baseline ECOG and comorbidity was noted in the SBRT cohort.

Radiotherapy in early stages of lung cancer

“…Con una mediana de 23,7 meses la supervivencia global fue de 24 meses en el grupo tratado con SBRT y 67 meses en el grupo tratado con intención radical no SBRT, sin embargo el porcentaje de recidiva fue menor en el grupo tratado con SBRT, aunque las diferencias no fueron significativas (24 vs 33%, p=0,173). Los autores consideran que la selección de tratamientos podría tener influencia en los resultados, siendo los pacientes tratados con SBRT los de peor PS [67]. A diferencia de estos resultados, se encuentran diferencias estadísticamente significativas en SG a favor del tratamiento con SBRT seguida o no de QT vs QT-RT convencional en el estudio de la Universidad de Vanderbilt con pacientes del National Cancer Database tratados entre 2004-2015, HR 0,63 p < 0,01, aunque estas diferencias no fueron significativas en el subgrupo de pacientes tratados con quimioterapia ajustado por factores de riesgo [68].…”