Time to CONVERT your BID radiation haters.

The long-awaited Phase 3 CONVERT trial published this week in Lancet failed to show that once-daily radiation was superior to twice-daily radiation for limited-stage SCLC. Median overall survival did not significantly differ for the 547 patients randomized to 45 Gy / 20 delivered BID (30 months) vs 66 Gy / 33 delivered daily (25 months). Everyone received cisplatin/etoposide x 4-6 cycles, and the only difference in toxicity was an 11% increase in G4 neutropenia in the BID arm. This should squelch criticisms of the 1999 Turrisi trial which first established a survival benefit with the BID regimen, including the one about dose-insufficiency in the control arm. And with a trend towards better survival, BID radiation can finally feel confident with its standard-care-of designation. So take a long lunch-break, BID-radiation, you earned it.


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