Lancet Oncology: Is the current standard radiotherapy regimen reasonable for limited-stage small cell lung cancer?

Lung cancer is the most common tumor in the world and the number one cause of death from cancer in my country.

At present, the international consensus is that simultaneous chemotherapy and radiotherapy is the standard treatment for limited-stage small cell lung cancer (LSSCLC).

This open-label, randomized, phase 2 trial was conducted in 22 public hospitals in Norway, Denmark and Sweden.

Participants were stratified according to ECOG performance status, disease stage and the presence of pleural effusion, and then randomly assigned (1:1), and received thoracic radiotherapy for 45 Gy for 30 times or 60 Gy for 20-28 days after the first chemotherapy course.

Patients in the two groups received radiotherapy 2 times a day and 10 times a week.

From July 8, 2014 to June 6, 2018, a total of 176 patients were enrolled in the group, of which 170 patients were randomly assigned to the 60 Gy (n=89) or 45 Gy (n=81) group.

The most common grade 3-4 adverse events were neutropenia (72 out of 89 patients in the 60 Gy group [81%] vs 62 out of 77 patients in the 45 Gy group [81%]), neutrophil infection (24 cases [27%] vs 30 cases [39%]), thrombocytopenia (21 cases [24%] vs 19 cases [25%]), anemia (14 cases [16%] vs 15 cases [20%]) And esophagitis (19 cases [21%] vs 14 cases [18%]).

Among them, 55 serious adverse events occurred in 38 patients in the 60 Gy group, and 56 serious adverse events occurred in 44 patients in the 45 Gy group.

references:

High-dose versus standard-dose twice-daily thoracic radiotherapy for patients with limited stage small-cell lung cancer: an open-label, randomised, phase 2 trial.