GOECP/SEOR radiotherapy guidelines for small-cell lung cancer

Couñago, Felipe; Pinta, Carolina de la; Gonzalo, Susana; Fernández, Castalia; Almendros, P.; Calvo, Patricia; Taboada, B.; Gómez-Caamaño, Antonio; Guerra, José Luis López; Chust, M.; Ferreira, José Antonio González; Gonzalez, A. Alvarez; Casas, Francesc

doi:10.5306/wjco.v12.i3.115

Cited by 8 publications

(10 citation statements)

References 183 publications

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“…Small cell lung cancer (SCLC) is a highly aggressive disease, which represents approximately 20% of all lung cancers. 1 As a unique subtype of lung cancer, SCLC disseminates early and often manifests at extensive stages, 2 constituting one of the leading cause of cancer death. It is conservatively estimated that 10–20% of SCLC patients are amalgamated with brain metastasis (BM) at onset, and 50–80% of them will eventually develop BM during the treatment process.…”

Section: Introductionmentioning

confidence: 99%

Brain Metastasis in Patients with Small Cell Lung Cancer

Li¹,

Chu²,

Song³

2021

IJGM

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Purpose To characterize the risk factors for brain metastasis (BM) at presentation and analyze the prognostic factors for patients with small cell lung cancer (SCLC). Patients and Methods Patients were recruited from the SEER database between 2010 and 2016. They were divided into two groups according to BM status. The incidence trends of SCLC and its BM were analyzed by joinpoint software. The risk factors for BM in SCLC were identified by binary logistic regression models. The prognostic factors for SCLC patients with BM were identified by Cox proportional hazard models. Results The incidence of SCLC and its BM significantly decreased after 2010. Totally 11,093 patients were collected, including 1717 (15.5%) patients with BM and 9376 (84.5%) patients without BM. In multivariate logistic regression analysis, age, male and higher T stage were independent risk factors for BM in SCLC patients at presentation. SCLC patients with BM showed inferior survival to those without BM. In multivariate Cox regression analysis, increasing age, large tumor size, and higher N stage were risk factors for poor prognosis, while other race, surgery, adjuvant radiotherapy, and chemotherapy were protective factors for SCLC patients with BM. A nomogram was developed for prognosis evaluation of such patients. Conclusion Age, male and higher T stage were risk factors for BM in SCLC patients at presentation. Increasing age, large tumor size, and advanced N stage may predict poor survival for SCLC patients with BM. Multidisciplinary therapies may provide clinical benefits. This study will help identify patients with higher BM risk and hopefully improve their clinical outcome.

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Section: Introductionmentioning

confidence: 99%

Brain Metastasis in Patients with Small Cell Lung Cancer

Li¹,

Chu²,

Song³

2021

IJGM

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“…For the first‐line treatment of ES‐SCLC, chemoimmunotherapy of platinum and etoposide combined with anti‐PD‐L1 antibodies including atezolizumab and durvalumab has been shown to improve survival and has become the standard of care. 1 , 5 , 6 , 7 In this treatment setting, the role of consolidative TRT is less clear. In this regard, a phase II/III RAPTOR trial (NRG Oncology LU‐007) is very important which compares the effect of adding RT (up to five sites including primary thoracic disease) to the usual maintenance therapy with atezolizumab versus atezolizumab alone in ES‐SCLC patients without progressive disease after four to six cycles of platinum plus etoposide chemotherapy combined with atezolizumab.…”

Section: Discussionmentioning

confidence: 99%

“… 1 Consolidative thoracic RT (TRT) is beneficial for selected patients with ES‐SCLC with complete response or good response to systemic therapy, especially with residual thoracic disease and low‐bulk extrathoracic metastatic disease. 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

“…Although patients with SCLC have been treated with systemic chemotherapy with or without radiation therapy (RT) and a significant minority of patients with SCLC are amenable to surgical resection, immune checkpoint inhibitors have been recently incorporated into the treatment for ES‐SCLC 1 . Consolidative thoracic RT (TRT) is beneficial for selected patients with ES‐SCLC with complete response or good response to systemic therapy, especially with residual thoracic disease and low‐bulk extrathoracic metastatic disease 5,6 …”

Section: Introductionmentioning

confidence: 99%

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Successful IMRT and concurrent chemotherapy for a patient with intrathoracic extensive‐stage small cell lung cancer

Horio

Tachibana

Shimizu

et al. 2022

Respirology Case Reports

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Treatment of extensive‐stage (ES) small cell lung cancer (SCLC) is a challenge with poor local control and dismal overall survival. Although single extrathoracic metastasis was defined as M1b according to the eighth edition of the tumour–node–metastasis (TNM) classification of lung cancer, M1b includes involvement of a single intrathoracic nonregional lymph node (LN) such as pericardial, internal mammary or paravertebral LNs. Here, we report a successful treated case of a 50‐year‐old female with ES‐SCLC with right pericardial LN involvement, cT1cN3M1b (LYM). She initially received two cycles of induction chemotherapy consisting of cis‐Diamminedichloroplatinum/cisplatin (CDDP) and etoposide and achieved a very good partial response. She then received curative chemoradiotherapy with intensity‐modulated techniques (45 Gy in 30 fractions BID), followed by an additional cycle of chemotherapy. She is free of recurrence for more than 2.5 years.

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“…Still, there is no specific study on the delineation of the target areas for extensive SCLC, and most centers follow the principle of target areas for localized SCLC. The gross tumor volume (GTV) is delineated according to the lesions shown in imaging data after chemotherapy, and the clinical tumor volume (CTV) is delineated by referring to the scope of lymph node invasion before chemotherapy, without preventive lymph node irradiation (40).…”

Section: Discussionmentioning

confidence: 99%

Effect of prior thoracic radiotherapy on prognosis in relapsed small cell lung cancer patients treated with anlotinib: a subgroup analysis of the ALTER 1202 trial

Liu¹,

Cheng²,

Li³

et al. 2021

Transl Lung Cancer Res

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Background: In ALTER 1202, anlotinib prolonged the progression-free survival (PFS) and overall survival (OS) of patients with relapsed small cell lung cancer (SCLC). The aim of this study was to explore the effect of front-line thoracic radiotherapy (RT) on the benefits of anlotinib as a third-line-or-beyond treatment.Methods: This was a subgroup analysis of a multicenter, randomized, double-blind, placebo-controlled phase 2 trial (ALTER 1202). The participants were divided into RT (previous thoracic RT) and non-RT subgroups. The outcomes included PFS, OS, objective response rate (ORR), disease control rate (DCR), and safety.Results: In the ALTER 1202 trial, 68 participants (anlotinib, n=46; placebo, n=22) received RT and 51 participants (anlotinib, n=35; placebo, n=16) did not. PFS was longer for anlotinib versus placebo in both the RT (5.49 vs. 0.69 months; P<0.001) and non-RT (2.83 vs. 0.76 months; P<0.001) subgroups. In the RT subgroup, the OS was longer for anlotinib vs. placebo (9.49 vs. 4.90 months; P=0.039). No differences were found in the ORR, but the DCR was higher in the anlotinib arm of the RT subgroup compared with the placebo arm (73.9% vs. 9.1%, P<0.001) and the non-RT subgroup (68.6% vs. 18.8%; P=0.002). Conclusions:In relapsed SCLC patients with previous thoracic RT, anlotinib might have DCR, PFS, and OS benefits compared with placebo. In those without previous thoracic RT patients, anlotinib might have DCR and PFS benefits compared with placebo. The safety was similar between anlotinib and placebo groups.

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GOECP/SEOR radiotherapy guidelines for small-cell lung cancer

Cited by 8 publications

References 183 publications

Brain Metastasis in Patients with Small Cell Lung Cancer

Brain Metastasis in Patients with Small Cell Lung Cancer

Successful IMRT and concurrent chemotherapy for a patient with intrathoracic extensive‐stage small cell lung cancer

Effect of prior thoracic radiotherapy on prognosis in relapsed small cell lung cancer patients treated with anlotinib: a subgroup analysis of the ALTER 1202 trial

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