SOCCAR: A randomised phase II trial comparing sequential versus concurrent chemotherapy and radical hypofractionated radiotherapy in patients with inoperable stage III Non-Small Cell Lung Cancer and good performance status

Maguire, Joseph I.; Khan, Iftekhar; McMenemin, R.; O’Rourke, N.; McNee, S.G.; Kelly, Virginia; Peedell, C.; Snee, M.

doi:10.1016/j.ejca.2014.07.009

Cited by 116 publications

(105 citation statements)

References 18 publications

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“…The 2-year survival rates were 50% vs 46% for concurrent and sequential arm, respectively. 19 The observations are in agreement with the findings in our report. However, the cumulative BED of the concurrent chemoradiation arms of the two studies were different (70 vs 59.5 Gy), and the relatively favourable grade $3 toxicity profile of the present study can be attributed to the less cumulative BED in the Arm B of our study.…”

supporting

confidence: 83%

“…Although the cumulative BED in the study arm of the present report is less than that used in the above studies, 12,[19][20][21] the response rates, toxicity and survival outcomes were consistent with reported literature. The consistency in the results among the studies underscores the fact that treatment acceleration is as important as achieving a higher BED and EQD2.…”

supporting

confidence: 80%

See 1 more Smart Citation

Accelerated hypofractionated radiotherapy with concomitant chemotherapy in locally advanced squamous cell carcinoma of lung: evaluation of response, survival, toxicity and quality of life from a Phase II randomized study

Roy

Pathy

Mohanti

et al. 2016

BJR

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Cite this article as: Roy S, Pathy S, Mohanti BK, Raina V, Jaiswal A, Kumar R, et al. Accelerated hypofractionated radiotherapy with concomitant chemotherapy in locally advanced squamous cell carcinoma of lung: evaluation of response, survival, toxicity and quality of life from a Phase II randomized study. Conclusion:The study suggests that AHFx-RT-CT is feasible for locally advanced SCC of the lung with improved response rate, survival, QOL and favourable toxicity. Advances in knowledge: To the best of our knowledge, this is the first study comparing conventionally fractionated radiation with AHFx-RT-CT. Addition of low-dose weekly cisplatin as radiosensitizer may be the potential factor responsible for improved response rate, survival and favourable toxicity in the study arm despite lower biological effective dose.

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supporting

confidence: 83%

supporting

confidence: 80%

Accelerated hypofractionated radiotherapy with concomitant chemotherapy in locally advanced squamous cell carcinoma of lung: evaluation of response, survival, toxicity and quality of life from a Phase II randomized study

Roy

Pathy

Mohanti

et al. 2016

BJR

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“…This regimen has not been formally tested against 2 Gy per fraction alternatives. It has been reported in a cohort study [14], comparing favourably with CHART and in a phase II trial [24] of sequential versus concurrent chemoradiation, in which it was shown to be tolerable and with promising disease control. Further studies should formally test the relative effectiveness and toxicity of this regimen.…”

Section: Discussionmentioning

confidence: 89%

The Quality of Curative-intent Radiotherapy for Non-small Cell Lung Cancer in the UK

McAleese¹,

Baluch²,

Drinkwater³

2015

Clinical Oncology

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“…Dose escalation by modified fractionation as the primary strategy to increase LC has been explored in several phase I and II studies . In 2015 the RTOG 0617 trial, which applied conventional dose escalation, was negative for the experimental arm in terms of LC and OS .…”

Section: Introductionmentioning

confidence: 99%

Radiation dose escalation with modified fractionation schedules for locally advanced NSCLC: A systematic review

Zehentmayr¹,

Grambozov²,

Kaiser³

et al. 2020

Thoracic Cancer

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Concomitant chemo-radiotherapy (cCRT) with 60 Gy in 30 fractions is the standard of care for stage 111 non-small cell lung cancer (NSCLC). With a median overall survival of 28.7 months at best and maximum locoregional control rates of 70% at two years, the prognosis for these patients is still dismal. This systematic review summarizes data on dose escalation by alternative fractionation, which has been explored as a primary strategy to improve both local control and overall survival over the past three decades. A Pubmed literature search was performed according to the PRISMA guidelines. Because of the large variety of radiation regimens total doses were converted to EQD 2,T . Only studies using an EQD 2,T of at least 49.5 Gy, which corresponds to the conventional 60 Gy in six weeks, were included. In a total of 3256 patients, the median OS was 17 months (range 7.4-30 months). While OS was better for patients treated after the year 2000 (P = 0.003) or with a mandatory 18 F-FDG-PET-CT in the diagnostic workup (P = 0.001), treatment sequence did not make a difference (P = 0.106). The most commonly reported toxicity was acute esophagitis (AE) with a median rate of 24% (range 0%-84%). AE increased at a rate of 0.5% per Gy increment in EQD 2,T (P = 0.016). Dose escalation above the conventional 60 Gy using modified radiation fractionation schedules and shortened OTT yield similar mOS and LRC regardless of treatment sequence with a significant EQD 2,T dependent increase in AE. Key pointsSignificant findings • Modified radiation dose escalation sequentially combined with chemotherapy yields similar outcome as concomitant treatment. • OS is better with the mandatory inclusion of FDG-PET-CT in the diagnostic work-up. • The risk of acute esophagitis increases with higher EQD 2,T . What this study adds • Chemo-radiotherapy (CRT) with modified dose escalation regimens yields OS and LC rates in the range of standard therapy regardless of treatment sequence. This broadens the database of curative options in patients who are not eligible concomitant CRT.

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SOCCAR: A randomised phase II trial comparing sequential versus concurrent chemotherapy and radical hypofractionated radiotherapy in patients with inoperable stage III Non-Small Cell Lung Cancer and good performance status

Cited by 116 publications

References 18 publications

Accelerated hypofractionated radiotherapy with concomitant chemotherapy in locally advanced squamous cell carcinoma of lung: evaluation of response, survival, toxicity and quality of life from a Phase II randomized study

Accelerated hypofractionated radiotherapy with concomitant chemotherapy in locally advanced squamous cell carcinoma of lung: evaluation of response, survival, toxicity and quality of life from a Phase II randomized study

The Quality of Curative-intent Radiotherapy for Non-small Cell Lung Cancer in the UK

Radiation dose escalation with modified fractionation schedules for locally advanced NSCLC: A systematic review

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