Consolidative Thoracic Radiation Therapy (cTRT) Plus Chemotherapy in Extensive-Stage Small Cell Lung Cancer (ES-SCLC)

Patients with extensive-stage small cell lung cancer (ES-SCLC) continue to face poor survival outcomes. Consolidative thoracic radiation therapy (cTRT) and upfront immunotherapy with chemotherapy have both improved survival outcomes; However, according to researchers Brett H. Diamond and colleagues, they “have not yet been combined in clinical trials.” After conducting a case series, the authors concluded that “treatment of ES-SCLC with first-line chemoimmunotherapy followed by cTRT appears to be safe and to have outcomes comparable to published modern clinical trials.”

The study, published in Advances in Radiation Oncology, reviewed 20 patients and had a median follow-up period of 12 months. Patients with ES-SCLC were treated with chemotherapy and immunotherapy, followed by cTRT. Outcomes of interest included overall survival, progression-free survival, local progression-free survival, distant progression-free survival, and toxicity.

The median overall survival for the cohort was 16 months, with a six-month overall survival rate of 94.7% and a 12-month overall survival rate of 77.5%, which the authors noted was comparable to historical controls. Furthermore, there were low reported rates of toxicity, “including 0% grade III or higher toxicities and grade II or higher pneumonitis, and 5% grade II esophagitis.”

Ultimately, the authors called for further studies to examine the potential benefits of cTRT after first-line chemoimmunotherapy.