Once daily versus twice-daily radiotherapy in the management of limited disease small cell lung cancer - Decision criteria in routine practise.


Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
09 2020
Historique:
received: 20 03 2020
revised: 24 04 2020
accepted: 03 05 2020
pubmed: 25 5 2020
medline: 15 4 2021
entrez: 25 5 2020
Statut: ppublish

Résumé

In limited disease small cell lung cancer (LD-SCLC), the CONVERT trial has not demonstrated superiority of once-daily (QD) radiotherapy (66 Gy) over twice-daily (BID) radiotherapy (45 Gy). We explored the factors influencing the selection between QD and BID regimens. Thirteen experienced European thoracic radiation oncologists as selected by the European Society for Therapeutic Radiation Oncology (ESTRO) were asked to describe their strategies in the management of LD-SCLC. Treatment strategies were subsequently converted into decision trees and analysed for agreement and discrepancies. Logistic reasons, patients' performance status and radiotherapy dose constraints were the three major decision criteria used by most experts in decision making. The use of QD and BID regimens was balanced among European experts, but there was a trend towards the BID regimen for fit patients able to travel twice a day to the radiotherapy site. BID and QD radiotherapy are both accepted regimens among experts and the decision is influenced by pragmatic factors such as availability of transportation.

Sections du résumé

BACKGROUND
In limited disease small cell lung cancer (LD-SCLC), the CONVERT trial has not demonstrated superiority of once-daily (QD) radiotherapy (66 Gy) over twice-daily (BID) radiotherapy (45 Gy). We explored the factors influencing the selection between QD and BID regimens.
METHODS
Thirteen experienced European thoracic radiation oncologists as selected by the European Society for Therapeutic Radiation Oncology (ESTRO) were asked to describe their strategies in the management of LD-SCLC. Treatment strategies were subsequently converted into decision trees and analysed for agreement and discrepancies.
RESULTS
Logistic reasons, patients' performance status and radiotherapy dose constraints were the three major decision criteria used by most experts in decision making. The use of QD and BID regimens was balanced among European experts, but there was a trend towards the BID regimen for fit patients able to travel twice a day to the radiotherapy site.
CONCLUSION
BID and QD radiotherapy are both accepted regimens among experts and the decision is influenced by pragmatic factors such as availability of transportation.

Identifiants

pubmed: 32447035
pii: S0167-8140(20)30246-2
doi: 10.1016/j.radonc.2020.05.004
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

26-29

Subventions

Organisme : Cancer Research UK
ID : 8154
Pays : United Kingdom

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Markus Glatzer (M)

Department of Radiation Oncology, Kantonsspital St. Gallen, Switzerland. Electronic address: markus.glatzer@kssg.ch.

Corinne Faivre-Finn (C)

Division of Cancer Sciences, University of Manchester & The Christie NHS Foundation Trust Manchester, United Kingdom.

Dirk De Ruysscher (D)

Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), School for Oncology and Developmental Biology (GROW), The Netherlands.

Joachim Widder (J)

Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria.

Paul Van Houtte (P)

Department Radiation Oncology, Institut Bordet, Université Libre Bruxelles, Belgium.

Esther G C Troost (EGC)

OncoRay - National Center for Radiation Research in Oncology, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus Dresden, Germany; Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Germany; German Cancer Consortium (DKTK), Partner Site Dresden, Germany; and German Cancer Research Center (DKFZ), Heidelberg, Germany.

M R Dahele (MR)

Department of Radiation Oncology, Amsterdam University Medical Center, VUMC, The Netherlands.

Ben J Slotman (BJ)

Department of Radiation Oncology, Amsterdam University Medical Center, VUMC, The Netherlands.

Sara Ramella (S)

Department of RadiationOncology, Campus Bio-Medico University, Rome, Italy.

Christoph Pöttgen (C)

Department of Radiation Oncology, West German Tumor Centre, University of Duisburg-Essen Medical School, Germany.

Stephanie T H Peeters (STH)

Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), School for Oncology and Developmental Biology (GROW), The Netherlands.

Ursula Nestle (U)

Department of Radiation Oncology, Kliniken Maria Hilf, Moenchengladbach, Germany; Department of Radiation Oncology, University Hospital Freiburg, Germany.

Fiona McDonald (F)

Department of Radiotherapy, The Royal Marsden NHS Foundation Trust, London, UK.

Cecile Le Pechoux (C)

Department of Radiation Oncology, Gustave Roussy, France.

Rafal Dziadziuszko (R)

Department of Oncology and Radiotherapy, Gdansk, Poland.

José Belderbos (J)

Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.

Paul M Putora (PM)

Department of Radiation Oncology, Kantonsspital St. Gallen, Switzerland; Department of Radiation Oncology, University of Bern, Switzerland.

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