A higher BID.

Top Line: Does dose escalation improve outcomes when using BID fractionation for limited stage small cell lung cancer?

The Study: Twice daily radiation is considered by many to be the standard when treating LS-SCLC. In the CONVERT trial (a superiority design), 66 Gy in 33 fractions was not superior to 45 Gy in 30 BID fractions. The ongoing CALGB 30610/RTOG 0528 trial is comparing 70 Gy in 35 fractions with 45 Gy in 30 BID fractions. Just to spice things up, here’s the randomized, phase 2 THORA trial that investigated whether dose escalation using BID fractionation improves overall survival. Patients with LS-SCLC (n = 170) received 4 q3 week cycles of cis/carbo and etoposide. They were randomized to 45 Gy in 30 BID fractions or 60 Gy in 40 BID fractions starting with the second chemo cycle and targeting the primary tumor and involved nodes. Dose constraints were comparable to those used for 60 Gy in 30 fractions. A dose reduction to 54 Gy was allowed in the 60 Gy arm if dose constraints were exceeded. Most patients (85%) also received PCI following completion of chemotherapy. At 2 years, 60 Gy/40 significantly improved the overall survival rate from 48.1→ 74.1% and median overall survival was improved from 23→ 37 months. Interestingly, there were no significant differences in local failure, distant failure, disease progression rates (63% vs 64%) or median PFS (18.6 vs 10.9 months) between arms. Toxicity was also surprisingly similar between arms with 21% vs 18% having grade 3 and 37% vs 44% having grade 1-2 esophagitis. Hmm. Looking forward to theMedNet commentary on this one.

TBL: According to the phase 2 THORA trial, dose escalation to 60 Gy in 40 fractions for LS-SCLC may improve overall survival without a significant increase in toxicity. | Gronberg, Lancet Oncol 2021

Comments

  1. To know more about Chief Dr Lucky you can visit his website (https://chiefdrluckyherbaltherapy.wordpress.com/)
     
     A friend that suffered from Herpes and was cure with the help of this great herbal doctor Chief Lucky so i decided to contact him for help in getting rid of my families genital herpes virus 1/2 which i did and all i was told to provide was just some useful information and some materials used in preparation of the natural cure and that i did and now i am the happiest person on earth because i am writing this testimony of mine with joy and happiness in my heart to the whole world to know that natural remedy is real because i am a living testimony of Chief Lucky traditional herbal cure and i want you all to contact Chief Lucky via his email: chiefdrlucky@gmail.com or WhatsApp him +2348132777335 am sure he will help you too.

    ReplyDelete

Post a Comment

Popular Posts