Advances in the radiotherapy treatment of SCLC


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Corinne Faivre-Finn1
1University of Manchester

Abstract

Major advances in SCLC have come from improvements in RT techniques. The role of thoracic radiotherapy is well established in the management of stage I-III SCLC . There is robust evidence in favour of early concurrent chemo-radiotherapy, and a standard of care for patients with a good performance status is twice-daily thoracic radiotherapy with concurrent cisplatin and etoposide. The CONVERT study (twice-daily versus once daily radiotherapy given concurrently with chemotherapy in stage I-III SCLC) was presented at ASCO 2016. It showed that once-daily radiotherapy did not result in a superior survival or worse toxicity than twice-daily radiotherapy , supporting the use of either regimen for standard of care treatmen. The survival for both regimens was higher than previously reported and using modern RT techniques radiation toxicities were lower than expected.

In the extensive-stage setting the CREST trial as shown that the addition on thoracic RT to chemotherapy and PCI leads to a significant reduction in intrathoracic recurrence and a significant improvement in overall survival at 2 years. PCI reduces the incidence of brain metastases and improves survival in all stages of SCLC It is crucial that patients with SCLC are given the opportunity to participate in clinical research in order to continue to improve the survival of this disease.