Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre

Objectives Most patients with small cell lung cancer present with extensive-stage (ES-SCLC) disease. An international randomised trial demonstrated a survival benefit in patients treated with consolidative thoracic radiotherapy (cTRT). We report our institutional experience with this regimen.Methods...

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Main Authors: Geoffrey Liu, Vijithan Sugumar, Frances Shepherd, Andrea Bezjak, Xiang Ye, Penelope A Bradbury, Natasha B Leighl, Andrew Hope, Adrian G Sacher, Rohan Salunkhe, Hadee Lone, Luna Zhan, Alexander Sun, John Cho, Srinivas Raman, Meredith Giuliani, Benjamin Lok
Format: Article
Language:English
Published: BMJ Publishing Group 2025-03-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/15/3/e093943.full
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author Geoffrey Liu
Vijithan Sugumar
Frances Shepherd
Andrea Bezjak
Xiang Ye
Penelope A Bradbury
Natasha B Leighl
Andrew Hope
Adrian G Sacher
Rohan Salunkhe
Hadee Lone
Luna Zhan
Alexander Sun
John Cho
Srinivas Raman
Meredith Giuliani
Benjamin Lok
author_facet Geoffrey Liu
Vijithan Sugumar
Frances Shepherd
Andrea Bezjak
Xiang Ye
Penelope A Bradbury
Natasha B Leighl
Andrew Hope
Adrian G Sacher
Rohan Salunkhe
Hadee Lone
Luna Zhan
Alexander Sun
John Cho
Srinivas Raman
Meredith Giuliani
Benjamin Lok
author_sort Geoffrey Liu
collection DOAJ
description Objectives Most patients with small cell lung cancer present with extensive-stage (ES-SCLC) disease. An international randomised trial demonstrated a survival benefit in patients treated with consolidative thoracic radiotherapy (cTRT). We report our institutional experience with this regimen.Methods A retrospective review was conducted on patients with ES-SCLC who were candidates for cTRT at our institution between 2013 and 2022. The patients included in our study had biopsy-proven ES-SCLC, received ≥4 cycles of chemotherapy and achieved complete response, partial response or stable disease as per Response Evaluation Criteria in Solid Tumors V.1.1. Overall survival, progression-free survival (PFS) and recurrence patterns were compared between patients who received cTRT and those who did not. For patients who received cTRT, treatment tolerability was assessed.Results We identified 123 patients with ES-SCLC who received ≥4 cycles of chemotherapy and were candidates for cTRT. Of those, 49 patients received cTRT, and 74 patients did not. From the end of chemotherapy, the control group had a median OS of 0.6 years with a 1- and 2-year OS of 23.5% and 11.0%. Within the cTRT group, the median OS was 0.9 years with a 1- and 2-year OS of 46.7% and 26.3%. Within the control group, the median PFS was 0.2 years compared with 0.4 years within the cTRT group. Intrathoracic failures in the cTRT group were lower compared with the control group (16.3% vs 29.7%). cTRT was well tolerated with no grade 3+ toxicities.Conclusion The improved clinical outcomes of cTRT for patients with ES-SCLC were comparable to the reported the Chest Radiotherapy Extensive-Stage Small Cell Lung Cancer Trial (CREST) outcome, with a low rate of side effects in our study cohort.
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spelling doaj-art-efb0122613af412eb016cc430445e56d2025-08-20T02:42:53ZengBMJ Publishing GroupBMJ Open2044-60552025-03-0115310.1136/bmjopen-2024-093943Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer CentreGeoffrey Liu0Vijithan Sugumar1Frances Shepherd2Andrea Bezjak3Xiang Ye4Penelope A Bradbury5Natasha B Leighl6Andrew Hope7Adrian G Sacher8Rohan Salunkhe9Hadee Lone10Luna Zhan11Alexander Sun12John Cho13Srinivas Raman14Meredith Giuliani15Benjamin Lok165 Division of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada1 Department of Medicine, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada5 Division of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada4 Department of Biostatistics, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada5 Division of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada5 Division of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada5 Division of Medical Oncology and Hematology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada3 Department of Radiation Oncology, University of Toronto Temerty Faculty of Medicine, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada4 Department of Biostatistics, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada2 Radiation Medicine Program, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, CanadaObjectives Most patients with small cell lung cancer present with extensive-stage (ES-SCLC) disease. An international randomised trial demonstrated a survival benefit in patients treated with consolidative thoracic radiotherapy (cTRT). We report our institutional experience with this regimen.Methods A retrospective review was conducted on patients with ES-SCLC who were candidates for cTRT at our institution between 2013 and 2022. The patients included in our study had biopsy-proven ES-SCLC, received ≥4 cycles of chemotherapy and achieved complete response, partial response or stable disease as per Response Evaluation Criteria in Solid Tumors V.1.1. Overall survival, progression-free survival (PFS) and recurrence patterns were compared between patients who received cTRT and those who did not. For patients who received cTRT, treatment tolerability was assessed.Results We identified 123 patients with ES-SCLC who received ≥4 cycles of chemotherapy and were candidates for cTRT. Of those, 49 patients received cTRT, and 74 patients did not. From the end of chemotherapy, the control group had a median OS of 0.6 years with a 1- and 2-year OS of 23.5% and 11.0%. Within the cTRT group, the median OS was 0.9 years with a 1- and 2-year OS of 46.7% and 26.3%. Within the control group, the median PFS was 0.2 years compared with 0.4 years within the cTRT group. Intrathoracic failures in the cTRT group were lower compared with the control group (16.3% vs 29.7%). cTRT was well tolerated with no grade 3+ toxicities.Conclusion The improved clinical outcomes of cTRT for patients with ES-SCLC were comparable to the reported the Chest Radiotherapy Extensive-Stage Small Cell Lung Cancer Trial (CREST) outcome, with a low rate of side effects in our study cohort.https://bmjopen.bmj.com/content/15/3/e093943.full
spellingShingle Geoffrey Liu
Vijithan Sugumar
Frances Shepherd
Andrea Bezjak
Xiang Ye
Penelope A Bradbury
Natasha B Leighl
Andrew Hope
Adrian G Sacher
Rohan Salunkhe
Hadee Lone
Luna Zhan
Alexander Sun
John Cho
Srinivas Raman
Meredith Giuliani
Benjamin Lok
Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre
BMJ Open
title Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre
title_full Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre
title_fullStr Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre
title_full_unstemmed Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre
title_short Retrospective cohort study assessing clinical outcomes of patients with extensive-stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the Princess Margaret Cancer Centre
title_sort retrospective cohort study assessing clinical outcomes of patients with extensive stage small cell lung cancer treated with and without consolidative thoracic radiotherapy at the princess margaret cancer centre
url https://bmjopen.bmj.com/content/15/3/e093943.full
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