Systematic Review Evaluating the Timing of Thoracic Radiation Therapy in Combined Modality Therapy for Limited-Stage Small-Cell Lung Cancer

Fried, Daniel B.; Morris, David E.; Poole, Charles; Rosenman, Julian G.; Halle, Jan; Detterbeck, Frank C.; Hensing, Thomas A.; Socinski, Mark A.

doi:10.1200/jco.2004.01.178

Cited by 345 publications

(188 citation statements)

References 33 publications

Supporting

Mentioning

173

Contrasting

Unclassified

Order By: Relevance

“…Compliance was important, suggesting that patient selection is important [19]. In a meta-analysis by Fried et al [20], late TRT was defined as beginning 9 weeks after the initiation of chemotherapy or after completion of the third cycle of chemotherapy. That meta-analysis showed a statistically significant benefit of early TRT over late TRT in terms of 2-year overall survival but not for 3-year overall survival.…”

Section: Timing Of Radiationmentioning

confidence: 99%

Limited-Stage Small Cell Lung Cancer: Current Chemoradiotherapy Treatment Paradigms

Stinchcombe

Gore

2010

The Oncologist

View full text Add to dashboard Cite

In the U.S., the prevalence of small cell lung cancer (SCLC) is declining, probably reflecting the decreasing prevalence of tobacco use. However, a significant number of patients will receive a diagnosis of SCLC, and approximately 40% of patients with SCLC will have limited-stage (LS) disease, which is potentially curable with the combination of chemotherapy and radiation therapy. The standard therapy for LS-SCLC is concurrent chemoradiotherapy, and the 5-year survival rate observed in clinical trials is approximately 25%. The standard chemotherapy remains cisplatin and etoposide, but carboplatin is frequently used in patients who cannot tolerate or have a contraindication to cisplatin. Substantial improvements in survival have been made through improvements in radiation therapy. Concurrent chemoradiotherapy is the preferred therapy for patients who are appropriate candidates. The optimal timing of concurrent chemoradiotherapy is during the first or second cycle, based on data from meta-analyses. The optimal radiation schedule and dose remain topics of debate, but 1.5 Gy twice daily to a total of 45 Gy and 1.8 -2.0 Gy daily to a total dose of 60 -70 Gy are commonly used treatments. For patients who obtain a near complete or complete response, prophylactic cranial radiation reduces the incidence of brain metastases and improves overall survival. The ongoing Radiation Therapy Oncology Group and Cancer and Leukemia Group B and the European and Canadian phase III trials will investigate different radiation treatment paradigms for patients with LS-SCLC, and completion of these trials is critical.

show abstract

Section: Timing Of Radiationmentioning

confidence: 99%

Limited-Stage Small Cell Lung Cancer: Current Chemoradiotherapy Treatment Paradigms

Stinchcombe

Gore

2010

The Oncologist

View full text Add to dashboard Cite

show abstract

“…(Pignon et al, 1992;Warde and Payne, 1992). Cisplatin plays a central role in concurrent treatment, because of its radiosensitising effect, and there is increasing evidence of a survival benefit for patients receiving early, concurrent, cisplatin-based chemoradiotherapy with 5-year survival ranging between 20 and 25% (Fried et al, 2004;Pijls-Johannesma et al, 2005). In this study, thoracic radiotherapy was given after the completion of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Phase III randomised trial of doxorubicin-based chemotherapy compared with platinum-based chemotherapy in small-cell lung cancer

et al. 2008

View full text Add to dashboard Cite

This randomised trial compared platinum-based to anthracycline-based chemotherapy in patients with small-cell lung cancer (limited or extensive stage) and p2 adverse prognostic factors. Patients were randomised to receive six cycles of either ACE (doxorubicin 50 mg/m 2 i.v., cyclophosphamide 1 g/m 2 i.v. and etoposide 120 mg/m 2 i.v. on day 1, then etoposide 240 mg/m 2 orally for 2 days) or PE (cisplatin 80 mg/m 2 and etoposide 120 mg/m 2 i.v. on day 1, then etoposide 240 mg/m 2 orally for 2 days) given for every 3 weeks. For patients where cisplatin was not suitable, carboplatin (AUC6) was substituted. A total of 280 patients were included (139 ACE, 141 PE). The response rates were 72% for ACE and 77% for PE. One-year survival rates were 34 and 38% (P ¼ 0.497), respectively and 2-year survival was the same (12%) for both arms. For LD patients, the median survival was 10.9 months for ACE and 12.6 months for PE (P ¼ 0.51); for ED patients median survival was 8.3 months and 7.5 months, respectively. More grades 3 and 4 neutropenia (90 vs 57%, Po0.005) and grades 3 and 4 infections (73 vs 29%, Po0.005) occurred with ACE, resulting in more days of hospitalisation and greater i.v. antibiotic use. ACE was associated with a higher risk of neutropenic sepsis than PE and with a trend towards worse outcome in patients with LD, and should not be studied further in this group of patients.

show abstract

“…A number of meta-analyses have shown a modest survival benefit with early compared with delayed concurrent TRT, most notably in combination with a cisplatin-based regimen (Fried et al, 2004;Huncharek and McGarry, 2004;Socinski and Stinchcombe, 2007). Additional analyses indicate that the overall treatment time for TRT, as well as the time of TRT initiation, influences survival.…”

Section: Chemoradiationmentioning

confidence: 99%

Treatment options for small cell lung cancer – do we have more choice?

et al. 2010

View full text Add to dashboard Cite

show abstract

Systematic Review Evaluating the Timing of Thoracic Radiation Therapy in Combined Modality Therapy for Limited-Stage Small-Cell Lung Cancer

Abstract: A small but significant improvement in 2-year OS for ERT versus LRT in LS-SCLC was observed, similar to the benefit of adding RT to chemotherapy or prophylactic cranial irradiation. A greater difference was evident for hyperfractionated RT and platinum-based chemotherapy.

Cited by 345 publications

References 33 publications

Limited-Stage Small Cell Lung Cancer: Current Chemoradiotherapy Treatment Paradigms

Limited-Stage Small Cell Lung Cancer: Current Chemoradiotherapy Treatment Paradigms

Phase III randomised trial of doxorubicin-based chemotherapy compared with platinum-based chemotherapy in small-cell lung cancer

Treatment options for small cell lung cancer – do we have more choice?

Contact Info

Product

Resources

About