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Once daily versus twice-daily radiotherapy in the management of limited disease small cell lung cancer - Decision criteria in routine practise

Markus Glatzer, Corinne Faivre-Finn, Dirk De Ruysscher, Joachim Widder, Paul Van Houtte, Esther G C Troost, M R Dahele, Ben J Slotman, Sara Ramella, Christoph Pöttgen, Stephanie T H Peeters, Ursula Nestle, Fiona McDonald, Cecile Le Pechoux, Rafal Dziadziuszko, José Belderbos & Paul Martin Putora

abstract

BACKGROUND
In limited disease small cell lung cancer (LD-SCLC), the CONVERT trial has not demonstrated superiority of once-daily (QD) radiotherapy (66 Gy) over twice-daily (BID) radiotherapy (45 Gy). We explored the factors influencing the selection between QD and BID regimens.

METHODS
Thirteen experienced European thoracic radiation oncologists as selected by the European Society for Therapeutic Radiation Oncology (ESTRO) were asked to describe their strategies in the management of LD-SCLC. Treatment strategies were subsequently converted into decision trees and analysed for agreement and discrepancies.

RESULTS
Logistic reasons, patients' performance status and radiotherapy dose constraints were the three major decision criteria used by most experts in decision making. The use of QD and BID regimens was balanced among European experts, but there was a trend towards the BID regimen for fit patients able to travel twice a day to the radiotherapy site.

CONCLUSION
BID and QD radiotherapy are both accepted regimens among experts and the decision is influenced by pragmatic factors such as availability of transportation.
   
citation Glatzer M, Faivre-Finn C, De Ruysscher D, Widder J, Van Houtte P, Troost E G C, Dahele M R, Slotman B J, Ramella S, Pöttgen C, Peeters S T H, Nestle U, McDonald F, Le Pechoux C, Dziadziuszko R, Belderbos J, Putora P M. Once daily versus twice-daily radiotherapy in the management of limited disease small cell lung cancer - Decision criteria in routine practise. Radiother Oncol 2020; 150:26-29.
   
type journal paper/review (English)
date of publishing 22-05-2020
journal title Radiother Oncol (150)
ISSN electronic 1879-0887
pages 26-29
PubMed 32447035
DOI 10.1016/j.radonc.2020.05.004