Long-Term Outcomes After Concurrent Once- or Twice-Daily Chemoradiation in Limited-Stage Small Cell Lung Cancer: A Brief Report From the CONVERT Trial

• DOI: 10.1016/j.ijrobp.2024.02.063
• Publication Date: 2024-03-21T15:01:00Z
• Authors: Gerard M. Walls; Hitesh Mistry; Fabrice Barlesi; Andrea Bezjak; Cecile Le Pechoux; Mary O'Brien; Jan P. Van Meerbeeck; Fiona Blackhall; Corinne Faivre-Finn
• Keywords: limited stage; Male; Adult; Lung Neoplasms; Time Factors; radiation therapy; hyperfractionation; Antineoplastic Combined Chemotherapy Protocols; Humans; /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; name=SDG 3 - Good Health and Well-being; Aged; Etoposide; Small cell lung cancer; Chemoradiotherapy; Middle Aged; Small Cell Lung Carcinoma; Treatment Outcome; Female; Human medicine; Dose Fractionation, Radiation; Radiotherapy, Intensity-Modulated; Cisplatin; Radiotherapy, Conformal; Cranial Irradiation; survivorship

IntroductionCONVERT was a phase 3 international randomized clinical trial comparing once-daily (OD) and twice-daily (BD) radiation therapy (RT). This updated analysis describes the 6.5 year outcomes of these regimes delivered with conformal techniques.MethodsCONVERT (NCT00433563) patients 1:1 between OD RT (66 Gy/33 fractions/6.5 weeks) BD (45 Gy/30 fractions/3 both concurrent cisplatin/etoposide. Three-dimensional mandatory, intensity-modulated permitted, elective nodal irradiation not allowed. Prophylactic cranial at discretion treating clinicians. treatment planning subject to central quality assurance.Results547 were recruited 73 centres. The median follow-up for surviving cohort (n=164) 81.2 months. survival arms 25.4 months (95%CI 21.1–30.9) 30.0 25.3–36.5), HR 1.13 0.92–1.38), p=0.247. Performance status tumour volume associated on multivariate analysis. No treatment-related deaths occurred subsequent initial performed in 2017. Regarding late toxicity, 7 arm developed grade esophagitis, 4 which went develop stricture or fistulation, compared no arm. Grade pulmonary fibrosis 2 respectively.ConclusionsAs CONVERT did demonstrate superiority this regime had slightly worse toxicity profile after 80 follow-up, 45 Gy should remain standard care limited stage small cell lung cancer.