Dataset Information

Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline.

ABSTRACT:

Purpose

Several sentinel phase III randomized trials have recently been published challenging traditional radiation therapy (RT) practices for small cell lung cancer (SCLC). This American Society for Radiation Oncology guideline reviews the evidence for thoracic RT and prophylactic cranial irradiation (PCI) for both limited-stage (LS) and extensive-stage (ES) SCLC.

Methods

The American Society for Radiation Oncology convened a task force to address 4 key questions focused on indications, dose fractionation, techniques and timing of thoracic RT for LS-SCLC, the role of stereotactic body radiation therapy (SBRT) compared with conventional RT in stage I or II node negative SCLC, PCI for LS-SCLC and ES-SCLC, and thoracic consolidation for ES-SCLC. Recommendations were based on a systematic literature review and created using a consensus-building methodology and system for grading evidence quality and recommendation strength.

Results

The task force strongly recommends definitive thoracic RT administered once or twice daily early in the course of treatment for LS-SCLC. Adjuvant RT is conditionally recommended in surgically resected patients with positive margins or nodal metastases. Involved field RT delivered using conformal advanced treatment modalities to postchemotherapy volumes is also strongly recommended. For patients with stage I or II node negative disease, SBRT or conventional fractionation is strongly recommended, and chemotherapy should be delivered before or after SBRT. In LS-SCLC, PCI is strongly recommended for stage II or III patients who responded to chemoradiation, conditionally not recommended for stage I patients, and should be a shared decision for patients at higher risk of neurocognitive toxicities. In ES-SCLC, radiation oncologist consultation for consideration of PCI versus magnetic resonance surveillance is strongly recommended. Lastly, the use of thoracic RT is strongly recommended in select patients with ES-SCLC after chemotherapy treatment, including a conditional recommendation in those responding to chemotherapy and immunotherapy.

Conclusions

RT plays a vital role in both LS-SCLC and ES-SCLC. These guidelines inform best clinical practices for local therapy in SCLC.

SUBMITTER: Simone CB

PROVIDER: S-EPMC10915746 | biostudies-literature | 2020 May - Jun

REPOSITORIES: biostudies-literature

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Publications

Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline.

Simone Charles B CB Bogart Jeffrey A JA Cabrera Alvin R AR Daly Megan E ME DeNunzio Nicholas J NJ Detterbeck Frank F Faivre-Finn Corinne C Gatschet Nancy N Gore Elizabeth E Jabbour Salma K SK Kruser Tim J TJ Schneider Bryan J BJ Slotman Ben B Turrisi Andrew A Wu Abraham J AJ Zeng Jing J Rosenzweig Kenneth E KE

Practical radiation oncology 20200323 3

<h4>Purpose</h4>Several sentinel phase III randomized trials have recently been published challenging traditional radiation therapy (RT) practices for small cell lung cancer (SCLC). This American Society for Radiation Oncology guideline reviews the evidence for thoracic RT and prophylactic cranial irradiation (PCI) for both limited-stage (LS) and extensive-stage (ES) SCLC.<h4>Methods</h4>The American Society for Radiation Oncology convened a task force to address 4 key questions focused on indic ...[more]

PMID: 32222430

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Dataset Information

Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline.

Purpose

Methods

Results

Conclusions

Publications

Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline.

Similar Datasets

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