Big agreement.

ASCO has officially endorsed the most recent ASTRO guidelines on the management of small cell lung cancer (SCLC). These recs include a strong preference for twice-daily over once-daily definitive radiation for limited-stage disease. Interestingly, for small node-negative cases, a stereotactic body radiation (SBRT) approach is recommended with equal weight as more protracted fractionation. For chemo-responders, there remain strong recommendations for prophylactic cranial irradiation (PCI), specifically 25Gy/10, for limited-stage disease and for a discussion of PCI versus MRI surveillance for extended-stage disease. Finally, there’s a strong recommendation for thoracic disease consolidation for chemo-responders with extensive-stage disease, though disagreement about the best fractionation. | Daly, J Clin Oncol 2021

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