Consolidative Thoracic Radiation Therapy After First-Line Chemotherapy and Immunotherapy in Extensive-Stage Small Cell Lung Cancer: A Multi-Institutional Case Series

Diamond, Brett H.; Verma, Nipun; Shukla, Utkarsh; Park, Henry S.; Koffer, P.P.

doi:10.1016/j.adro.2021.100883

Cited by 19 publications

(25 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…]. Nevertheless, the exact association between OS and cTRT could not be predicted precisely due to the study's retrospective nature and the low number of included patients (Table 1) [5]. Similar toxicity profiles were reported in a recent prospective single-arm phase 1/2 study [27].…”

Section: Andandmentioning

confidence: 63%

“…According to their results, cTRT appears to be well tolerated with low rates of toxicities, and the observed median OSs were comparable to the results of the modern clinical trials (CREST, IMpower133 and CASPIAN) [6 ▪ ,26 ▪▪ ]. Nevertheless, the exact association between OS and cTRT could not be predicted precisely due to the study's retrospective nature and the low number of included patients (Table 1) [5]. Similar toxicity profiles were reported in a recent prospective single-arm phase 1/2 study [27].…”

Section: Consolidation Thoracic Radiotherapy In Patients With Extensi...mentioning

confidence: 80%

“…Accordingly, only a few studies attempted so far to assess the role of cTRT and its antitumor activity in patients receiving immunotherapeutic agents. In a recent two-center retrospective study, Diamond et al [5] evaluated the efficacy and safety of cTRT (median dose: 30 Gy, median fraction number: 10) in a small cohort of twenty ES-SCLC patients treated with first-line platinum-based chemotherapy (carboplatin or cisplatin), etoposide and atezolizumab immunotherapy. Notably, none of the included patients received PCI.…”

Section: Consolidation Thoracic Radiotherapy In Patients With Extensi...mentioning

confidence: 99%

“…This is mainly because several main factors are inconsistent in these studies thus hindering their comparability with each other. These factors include among others: examination of the severity of adverse effects, presence or absence of any baseline imaging examination; radiation dose and frequency, type and dose of first-line chemotherapy/chemo-immunotherapy, follow-up and staging outcomes with magnetic resonance imaging (MRI) [5,[18][19][20][21]. Accordingly, while some studies suggest a clear survival benefit in patients receiving PCI, others support the idea that strict MRI-based follow up is actually superior to PCI [18][19][20][21].…”

Section: Prophylactic Cranial Irradiationmentioning

confidence: 99%

“…In this study, the addition of atezolizumab to the standard platinum–etoposide backbone improved both the progression-free survival (PFS) and overall survival (OS) of immunotherapy-treated patients (by 0.9 and 2 months, respectively) [1,2]. Furthermore, the efficacy of prophylactic cranial irradiation (PCI) and consolidative thoracic radiation therapy (cTRT) with continuation of front-line systemic chemo-immunotherapy as maintenance is also under investigation for ES disease [5,6 ▪ ]…”

Section: Introductionmentioning

confidence: 98%

See 4 more Smart Citations

Thoracic irradiation as consolidation therapy in patients with extensive-stage small cell lung cancer

Berta

Rózsás

Ostoros

et al. 2022

Current Opinion in Oncology

View full text Add to dashboard Cite

Purpose of reviewSmall cell lung cancer (SCLC) is marked by an exceptionally high proliferative rate and poor prognosis. Given its high propensity to metastasize, nearly two-thirds of SCLC patients are diagnosed with extensive-stage (ES) disease when surgery is not a treatment option anymore. Over several decades, only minimal changes have been made in the therapeutic armamentarium of ES-SCLC. Recently, however, several new therapeutic avenues were defined, thus renewing the hope for patients with this recalcitrant cancer. Here, we present an overview of the most current therapeutic advances in ES-SCLC focusing in particular on consolidative thoracic radiation therapy (cTRT) and chemo-immunotherapy.Recent findingsThe incorporation of immunotherapy in the standard-of-care of ES-SCLC patients and the resulting outcomes are both a remarkable hallmark of progress and a disappointment. Indeed, chemo-immunotherapy with or without cTRT and prophylactic cranial irradiation contributes to longer survival outcomes with minimal toxicity rates in well selected and properly monitored patients. Nevertheless, the gain in overall survival is still modest relative to that seen in many other solid tumors.SummaryDespite the encouraging results, further clinical trials are needed to determine the efficacy and safety of these therapeutic approaches, and moreover, to identify new predictive biomarkers of response.

show abstract

Section: Andandmentioning

confidence: 63%

Section: Consolidation Thoracic Radiotherapy In Patients With Extensi...mentioning

confidence: 80%

Section: Consolidation Thoracic Radiotherapy In Patients With Extensi...mentioning

confidence: 99%

Section: Prophylactic Cranial Irradiationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 98%

See 3 more Smart Citations

Thoracic irradiation as consolidation therapy in patients with extensive-stage small cell lung cancer

Berta

Rózsás

Ostoros

et al. 2022

Current Opinion in Oncology

View full text Add to dashboard Cite

show abstract

Progress in radiotherapy for small‐cell lung cancer

Yang,

Zhao

2023

Precision Radiation Oncology

View full text Add to dashboard Cite

Small‐cell lung cancer (SCLC) is a highly aggressive neuroendocrine tumor that is prone to spread extensively. Compared to non‐small‐cell lung cancer (NSCLC), SCLC treatment progresses slowly. Although SCLC is highly sensitive to chemotherapy during the initial treatment, most patients still experience resistance and recurrence after receiving chemotherapy. A meta‐analysis demonstrated that thoracic radiotherapy (TRT) improves overall survival in SCLC. The results of the CALGB and CONVERT trials provide evidence for the efficacy of once‐daily high‐dose TRT. TRT at 60 Gy administered twice daily significantly improved survival without increasing toxicity. The long‐standing debate over the optimal timing of radiotherapy has not been fully resolved. SBRT has excellent local control rates and is a safe and effective treatment option for patients with stage I or II SCLC. Prophylactic cranial irradiation (PCI) is used to reduce treatment‐related neurotoxicity to the extent that there has been a recent discussion on whether magnetic resonance imaging (MRI) monitoring can replace PCI. Radiotherapy combined with immunotherapy significantly improves the survival rate of patients with NSCLC; however, its clinical effectiveness has not been systematically explored in patients with SCLC. Therefore, we summarize the evolving therapeutic strategies, (TRT for limited stage‐SCLC and consolidative TRT for extensive stage‐SCLC) and improved radiotherapy techniques (role of SBRT in stage I or II node‐negative SCLC, progress of PCI, and stereotactic radiosurgery), and discuss the possibilities and prospects of radiotherapy combined with immunotherapy for SCLC.

show abstract

Chinese clinical practice guidelines for the prevention and treatment of radiation‐induced esophagitis

Yang,

Wang,

Yuan

2023

Precision Radiation Oncology

View full text Add to dashboard Cite

Radiation‐induced dermatitis is one of the most prevalent complications in patients undergoing cancer radiotherapy and poses a significant challenge in cancer therapy. The symptoms encompass erythema, dry desquamation, and moist desquamation, which are frequently observed in patients with breast cancer, head and neck cancer, anal cancer, and vulvar cancer. Early skin reactions typically manifest within 2 to 4 weeks following the commencement of radiotherapy.In severe cases, acute dermatitis can cause radiotherapy interruptions, prolong treatment time, and ultimately affect patients' outcomes and quality of life. At present, there are numerous guidelines on radiation dermatitis abroad, including the Multinational Association of Supportive Care in Cancer (MASCC), British Columbia Cancer Agency (BCCA), Oncology Nursing Society (ONS), and UK Society of Radiographers (SCoR) guidelines. In China, there was a consensus drafted by dermatology experts. However, due to the differing backgrounds of experts, recommendations between guidelines vary. This guideline was developed for the first time by the Chinese radiation oncologist. This evidence‐based guideline fully considers and adopts China's national conditions; hence, itcan be easily applied in our daily practice.

show abstract

Consolidative Thoracic Radiation Therapy After First-Line Chemotherapy and Immunotherapy in Extensive-Stage Small Cell Lung Cancer: A Multi-Institutional Case Series

Cited by 19 publications

References 24 publications

Thoracic irradiation as consolidation therapy in patients with extensive-stage small cell lung cancer

Thoracic irradiation as consolidation therapy in patients with extensive-stage small cell lung cancer

Progress in radiotherapy for small‐cell lung cancer

Chinese clinical practice guidelines for the prevention and treatment of radiation‐induced esophagitis

Contact Info

Product

Resources

About