Clinical trial of post-chemotherapy consolidation thoracic radiotherapy for extensive-stage small cell lung cancer

Abstract Background and purpose To define the rate of development of symptomatic chest failures in extensive stage small cell lung cancer (ES-SCLC) after undergoing post-chemotherapy chest radiotherapy (RT). Materials and methods Patients had ES-SCLC, attained an objective response to chemotherapy a...

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Bibliographic Details
Published in:Radiotherapy and oncology 2012-02, Vol.102 (2), p.234-238
Main Authors: Yee, Don, Butts, Charles, Reiman, Anthony, Joy, Anil, Smylie, Michael, Fenton, David, Chu, Quincy, Hanson, John, Roa, Wilson
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Antineoplastic Agents - administration & dosage
Brain Neoplasms - prevention & control
Brain Neoplasms - secondary
Carboplatin - administration & dosage
Cisplatin - administration & dosage
Combined Modality Therapy
Consolidation chest radiotherapy
Cranial Irradiation
Disease Progression
Dose Fractionation
Extensive stage
Female
Hematology, Oncology and Palliative Medicine
Humans
Lung Neoplasms - drug therapy
Lung Neoplasms - pathology
Lung Neoplasms - radiotherapy
Male
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Radiotherapy Dosage
Small cell lung cancer
Small Cell Lung Carcinoma - drug therapy
Small Cell Lung Carcinoma - pathology
Small Cell Lung Carcinoma - radiotherapy
Survival Rate
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Summary:Abstract Background and purpose To define the rate of development of symptomatic chest failures in extensive stage small cell lung cancer (ES-SCLC) after undergoing post-chemotherapy chest radiotherapy (RT). Materials and methods Patients had ES-SCLC, attained an objective response to chemotherapy and signed study consent. Target accrual was 33 patients. Patients were offered prophylactic cranial irradiation (PCI) as per department policy. PCI (25 Gy/10 fractions) and chest RT (40 Gy/15 fractions) were given simultaneously 4–8 weeks after chemotherapy completion. Thoracic target volume was the post-chemotherapy residual chest disease plus margin. Patients were evaluated for RT toxicities, local control, disease-free and overall survival. Results Thirty-two patients were evaluable. Twenty-nine patients completed RT without delay. There were 4 complete responses and 28 partial responses to chemotherapy. All study patients received PCI. Maximal acute RT toxicity was grade 2 esophagitis (18 patients). There were no RT-related deaths. Median time to disease progression and overall survival were 4.2 and 8.3 months, respectively (median follow-up = 21.8 months). Of 16 chest recurrences, 7 were in the irradiated region and 5 were symptomatic. Conclusions Post-chemotherapy consolidation chest RT for ES-SCLC patients on this trial was well tolerated and associated with symptomatic chest recurrences in only 5/32 treated patients.
ISSN:0167-8140
1879-0887
DOI:10.1016/j.radonc.2011.08.042