Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung Cancer
Objectives: Extensive-stage small-cell lung cancer (SCLC) has a poor prognosis, but recently, the combination of immunotherapy and chemotherapy has improved treatment outcomes in some patients, and treatment plans may vary depending on the individual’s general condition and tumor response. In additi...
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MDPI AG
2025-05-01
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| author | Hakyoung Kim Jeongeun Hwang Sun Myung Kim Dae Sik Yang |
| author_facet | Hakyoung Kim Jeongeun Hwang Sun Myung Kim Dae Sik Yang |
| author_sort | Hakyoung Kim |
| collection | DOAJ |
| description | Objectives: Extensive-stage small-cell lung cancer (SCLC) has a poor prognosis, but recently, the combination of immunotherapy and chemotherapy has improved treatment outcomes in some patients, and treatment plans may vary depending on the individual’s general condition and tumor response. In addition, intrathoracic tumor control remains a major challenge for this disease. In the current study, we aim to share our clinical experience and demonstrate that consolidative high-dose thoracic radiotherapy effectively reduces intrathoracic tumor recurrence while maintaining acceptable treatment-related toxicities. Materials and Methods: The medical records of 81 SCLC patients treated at Korea University Guro Hospital from January 2019 to December 2023 were reviewed retrospectively. Among them, 22 patients with extensive-stage SCLC who had a favorable tumor response after systemic therapy, including those with oligo-progressive disease limited to the thoracic region and suitable for curative local therapy, received consolidative radiotherapy. A total dose of 52.5 Gy in 25 fractions was administered over 5 weeks to all patients with extensive-stage SCLC. Results and Conclusions: The median follow-up time was 22 months (range: 8–59 months), with the median follow-up period after completing consolidative radiotherapy being 13 months (range: 4–35 months). In-field local recurrence occurred in only one patient after consolidative thoracic radiotherapy. Most importantly, 10 patients with oligo-progressive disease at the thoracic site, at the time of tumor response, remained stable without further intrathoracic in-field recurrence. Additionally, no severe cases of radiation pneumonitis or esophagitis were observed. Based on our institution’s experience, consolidative high-dose thoracic radiotherapy is well-tolerated and associated with fewer intrathoracic recurrences, leading to improved long-term survival in carefully selected patients with extensive-stage SCLC. Given these findings, we believe consolidative radiotherapy should be considered more proactively in clinical practice. Furthermore, these results may help guide the design of future clinical trials. |
| format | Article |
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| language | English |
| publishDate | 2025-05-01 |
| publisher | MDPI AG |
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| series | Tomography |
| spelling | doaj-art-2969147bc88748de9cec990937d1fcf72025-08-20T02:33:55ZengMDPI AGTomography2379-13812379-139X2025-05-011155510.3390/tomography11050055Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung CancerHakyoung Kim0Jeongeun Hwang1Sun Myung Kim2Dae Sik Yang3Departments of Radiation Oncology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 02841, Republic of KoreaDepartment of Medical IT Engineering, College of Software Convergence, Soonchunhyang University, Asan 31538, Republic of KoreaDepartments of Radiation Oncology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 02841, Republic of KoreaDepartments of Radiation Oncology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 02841, Republic of KoreaObjectives: Extensive-stage small-cell lung cancer (SCLC) has a poor prognosis, but recently, the combination of immunotherapy and chemotherapy has improved treatment outcomes in some patients, and treatment plans may vary depending on the individual’s general condition and tumor response. In addition, intrathoracic tumor control remains a major challenge for this disease. In the current study, we aim to share our clinical experience and demonstrate that consolidative high-dose thoracic radiotherapy effectively reduces intrathoracic tumor recurrence while maintaining acceptable treatment-related toxicities. Materials and Methods: The medical records of 81 SCLC patients treated at Korea University Guro Hospital from January 2019 to December 2023 were reviewed retrospectively. Among them, 22 patients with extensive-stage SCLC who had a favorable tumor response after systemic therapy, including those with oligo-progressive disease limited to the thoracic region and suitable for curative local therapy, received consolidative radiotherapy. A total dose of 52.5 Gy in 25 fractions was administered over 5 weeks to all patients with extensive-stage SCLC. Results and Conclusions: The median follow-up time was 22 months (range: 8–59 months), with the median follow-up period after completing consolidative radiotherapy being 13 months (range: 4–35 months). In-field local recurrence occurred in only one patient after consolidative thoracic radiotherapy. Most importantly, 10 patients with oligo-progressive disease at the thoracic site, at the time of tumor response, remained stable without further intrathoracic in-field recurrence. Additionally, no severe cases of radiation pneumonitis or esophagitis were observed. Based on our institution’s experience, consolidative high-dose thoracic radiotherapy is well-tolerated and associated with fewer intrathoracic recurrences, leading to improved long-term survival in carefully selected patients with extensive-stage SCLC. Given these findings, we believe consolidative radiotherapy should be considered more proactively in clinical practice. Furthermore, these results may help guide the design of future clinical trials.https://www.mdpi.com/2379-139X/11/5/55small cell lung cancerextensive stageradiotherapylocal controlsurvival |
| spellingShingle | Hakyoung Kim Jeongeun Hwang Sun Myung Kim Dae Sik Yang Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung Cancer Tomography small cell lung cancer extensive stage radiotherapy local control survival |
| title | Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung Cancer |
| title_full | Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung Cancer |
| title_fullStr | Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung Cancer |
| title_full_unstemmed | Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung Cancer |
| title_short | Preliminary Results of Clinical Experience with Consolidative High-Dose Thoracic Radiotherapy for Patients with Extensive-Stage Small Cell Lung Cancer |
| title_sort | preliminary results of clinical experience with consolidative high dose thoracic radiotherapy for patients with extensive stage small cell lung cancer |
| topic | small cell lung cancer extensive stage radiotherapy local control survival |
| url | https://www.mdpi.com/2379-139X/11/5/55 |
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