Thoracic Radiotherapy in Limited-Stage SCLC-a Population-Based Study of Patterns of Care in Norway From 2000 Until 2018.

Autor: Graabak G; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway., Grønberg BH; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.; Department of Oncology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway., Sandvei MS; Department of Oncology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.; Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway., Nilssen Y; Department of Registration, Cancer Registry of Norway, Oslo, Norway., Halvorsen TO; Department of Clinical and Molecular Medicine, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.; Department of Oncology, St Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
Jazyk: angličtina
Zdroj: JTO clinical and research reports [JTO Clin Res Rep] 2021 Dec 18; Vol. 3 (2), pp. 100270. Date of Electronic Publication: 2021 Dec 18 (Print Publication: 2022).
DOI: 10.1016/j.jtocrr.2021.100270
Abstrakt: Introduction: Twice-daily (BID) thoracic radiotherapy (TRT) of 45 Gy per 30 fractions is recommended for limited-stage (LS) SCLC, but most patients are treated with once-daily (OD) schedules owing to toxicity concerns and logistic challenges. An alternative is hypofractionated OD TRT of 40 to 42 Gy per 15 fractions. A randomized trial by our group indicated that TRT of 45 Gy per 30 fractions is more effective than TRT of 42 Gy per 15 fractions, and because it was not more toxic, 45 BID replaced 42 OD as the recommended schedule in Norway. The aims of this study were to evaluate to what extent BID TRT has been implemented in Norway and whether this practice change has led to improved survival.
Methods: Data on all patients diagnosed with LS SCLC from 2000 until 2018 were collected from the Cancer Registry of Norway, containing nearly complete data on cancer diagnosis, radiotherapy, and survival.
Results: A total of 2222 patients were identified; median age was 69 years, 51.8% were women, and 87.1% had stage II to III disease. Overall, 64.6% received TRT. The use of BID TRT increased from 1.8% (2000-2004) to 83.2% (2015-2018). Median overall survival among patients receiving curative TRT improved significantly during the study period (2000-2004: 17.9 mo, 2015-2018: 25.0 mo, p  = 0.0023), and patients receiving 45 BID had significantly longer median overall survival than patients receiving 42 OD (BID: 26.2 mo, OD: 19.6 mo, p  = 0.0015).
Conclusions: BID TRT has replaced hypofractionated OD TRT as the standard treatment of LS SCLC in Norway which has led to a significant ( p = 0.0023) and clinically relevant survival improvement.
(© 2021 The Authors.)
Databáze: MEDLINE
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