In a nutshell
The study aimed to investigate the safety, tolerability, and effectiveness of high-dose thoracic radiotherapy for limited-stage (LS) small-cell lung cancer patients (SCLC). The study concluded the high dose of thoracic radiotherapy improved the survival of these patients without increasing toxicity.
Lung cancer is the second most common cancer in the USA. About 13% of all lung cancers are SCLC. SCLC is an aggressive form of lung cancer. Chemotherapy (CT) combined with radiotherapy (RT) is the standard treatment for limited-stage (LS; when cancer spread is limited to one lung) SCLC.
The standard dose of RT for these patients is twice-daily thoracic radiotherapy of 45 Gy. However, relapses are still common. It was unknown if a higher dose of RT would further improve the outcomes of these patients and if it would be safe.
Methods & findings
170 patients with LS-SCLC were involved in this study. The patients were randomly assigned to receive either standard RT (group 1) or high-dose RT (group 2). Group 1 had 81 patients that received 45 Gy in 30 twice-daily sessions and group 2 had 89 patients that received 60 Gy in 40 twice-daily sessions. All patients also received 4 courses of CT along with thoracic RT. Patients were followed up with a CT scan for a minimum of 2 years.
After 2 years, 74.2% of patients in group 2 and 48.1% of group 1 were alive. The average overall survival for group 2 was significantly longer (37.2 months) compared to group 1 (22.6 months). The average survival without cancer worsening was 18.6 months for group 2 versus 10.9 months for group 1. A higher RT dose was associated with a 32% lower risk of cancer worsening.
There was no difference in side effects between the two treatment groups.
The bottom line
The study concluded that a higher dose of 60 Gy RT improved survival without increased toxicity in patients with LS-SCLC.
The fine print
The study included a small number of participants. The study is ongoing for evaluating long-term results.
Published By :
The Lancet. Oncology
Mar 01, 2021