Current management of limited-stage SCLC and CONVERT trial impact: Results of the EORTC Lung Cancer Group survey

Antonin Levy*, Lizza E. L. Hendriks, Cecile Le Pechoux, Sally Falk, Benjamin Besse, Silvia Novello, Anne-Marie C. Dingemans, Baktiar Hasan, Martin Reck, Thierry Berghmans, Corinne Faivre-Finn, EORTC Lung Cancer Group

*Corresponding author for this work

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Abstract

Objectives: The CONVERT trial showed that twice-daily (BD) concurrent chemoradiotherapy should continue to be considered the standard of care in localised LS-SCLC. A survey was conducted to assess the impact of the CONVERT trial in clinical practice and to identify any relevant research questions for future trials in this setting.

Methods and materials: An EORTC Group online survey of LS-SCLC practice was distributed to the EORTC LCG and to members of several European thoracic oncology societies between April and December 2018.

Results: 198 responses were analysed. The majority of respondents (88%, n = 174) were aware of the CONVERT trial. Radiation oncologists comprised 56% of all respondents. Once-daily (OD) radiotherapy is still the most commonly used regimen, however the use of concurrent BD radiotherapy increased after the publication of CONVERT (n = 59/186, 32% prior to and n = 78/187, 42% after the publication, p = 0.053). The main reasons for not implementing BD after the CONVERT publication were logistical issues (n = 88, 44%), inconvenience for patients (n = 56, 28%), and the absence of a statistical survival difference between the two arms in CONVERT (n = 38, 19%). Brain MRI was used by 28% during staging but more than half (60%) of the respondents did not routinely image the brain during follow-up. The main research questions of interest in LS-SCLC were 1) integrating novel targeted therapies-immunotherapies (n =. 160, 81%), 2) PCI (+/- hippocampal sparing) vs. MRI surveillance (n = 140, 71%) and, 3) biomarker driven trials (n = 92, 46%).

Conclusion: Once daily radiotherapy (60-66 Gy in 30-33 fractions) remains the most prescribed radiotherapy fractionation, despite the findings suggested by the CONVERT trial.

Original languageEnglish
Pages (from-to)145-147
Number of pages3
JournalLung Cancer
Volume136
DOIs
Publication statusPublished - Oct 2019
Event38th Annual Meeting of the European-Society-for-Radiotherapy-and-Oncology (ESTRO) - Barcelona, SPAIN, Milan, Italy
Duration: 26 Apr 201930 Apr 2019
Conference number: 37

Keywords

  • Small-cell lung cancer
  • Limited-stage
  • Thoracic radiotherapy
  • Fractionation
  • THORACIC RADIOTHERAPY
  • IRRADIATION

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