Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline
Autor: | Nancy Gatschet, Megan E. Daly, Frank C. Detterbeck, Alvin R. Cabrera, Nicholas J. DeNunzio, Charles B. Simone, Salma K. Jabbour, Abraham J. Wu, Jeffrey A. Bogart, Corinne Faivre-Finn, Andrew Turrisi, Tim J. Kruser, Kenneth E. Rosenzweig, Elizabeth Gore, Jing Zeng, Ben J. Slotman, Bryan J. Schneider |
---|---|
Přispěvatelé: | Radiation Oncology, CCA - Cancer Treatment and quality of life |
Rok vydání: | 2020 |
Předmět: |
Oncology
Male medicine.medical_specialty Lung Neoplasms medicine.medical_treatment 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine medicine Humans Radiology Nuclear Medicine and imaging neoplasms Radiation oncologist business.industry Dose fractionation Guideline Small Cell Lung Carcinoma respiratory tract diseases Radiation therapy Clinical trial 030220 oncology & carcinogenesis Conventional PCI Female Prophylactic cranial irradiation business |
Zdroj: | Simone, C B, Bogart, J A, Cabrera, A R, Daly, M E, DeNunzio, N J, Detterbeck, F, Faivre-Finn, C, Gatschet, N, Gore, E, Jabbour, S K, Kruser, T J, Schneider, B J, Slotman, B, Turrisi, A, Wu, A J, Zeng, J & Rosenzweig, K E 2020, ' Radiation Therapy for Small Cell Lung Cancer : An ASTRO Clinical Practice Guideline ', Practical Radiation Oncology, vol. 10, no. 3, pp. 158-173 . https://doi.org/10.1016/j.prro.2020.02.009 Practical Radiation Oncology, 10(3), 158-173. Elsevier BV |
ISSN: | 1879-8519 1879-8500 |
Popis: | 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. |
Databáze: | OpenAIRE |
Externí odkaz: |