2022 World Conference on Lung Cancer (ePosters)-EP14.03-005. Role of Radiotherapy Fraction in Limited-Stage SCLC: a Meta-Analysis of 8585 Reconstructed Individual Patient Data

EP14.03-005. Role of Radiotherapy Fraction in Limited-Stage SCLC: a Meta-Analysis of 8585 Reconstructed Individual Patient Data

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A systematic review and meta-analysis was conducted to assess the optimal thoracic radiotherapy (TRT) dose and fractionation for limited-stage small-cell lung cancer (LS-SCLC) in the modern radiation era. The analysis included 53 publications and a total of 8006 reconstructed individual patient data (IPD). Overall survival rates were compared between different TRT regimens. Hypofractionated TRT (HypoTRT) was found to be similar to hyperfractionated TRT (HyperTRT) and conventional TRT (ConvTRT) in terms of overall survival rates. However, ConvTRT was inferior to HyperTRT. The results remained consistent after adjusting for key treatment variables. In patients who received modern 3D conformal or intensity-modulated radiotherapy (3D-CRT/IMRT), survival outcomes were comparable among the different fractionation regimens. The findings from a Bayesian network meta-analysis using aggregated data (AD) were consistent with those from the individual patient data analysis.<br /><br />The analysis also compared the incidence of radiation-related adverse events between the different TRT fraction modalities. Pooled estimates showed that grade 3-5 radiation esophagitis (RE) was higher in HyperTRT compared to HypoTRT and ConvTRT. However, the incidence of radiation pneumonitis (RP) was similar among the three schedules. In the subgroup of patients who received 3D-CRT/IMRT, there were no significant differences in severe RE or RP.<br /><br />Overall, the study concluded that in the modern radiation therapy era, HypoTRT, ConvTRT, and HyperTRT have comparable survival outcomes and induce similar toxicity effects in LS-SCLC patients treated with definitive chemoradiotherapy. The feasibility of HypoTRT should be confirmed in prospective randomized phase III trials.

Asset Subtitle

Jingjing Zhao

Meta Tag

Speaker Jingjing Zhao

Topic Small Cell Lung Cancer and Neuro-endocrine Tumours - RT

Keywords

systematic review

meta-analysis

thoracic radiotherapy

TRT dose

fractionation

limited-stage small-cell lung cancer

overall survival rates

hypofractionated TRT

hyperfractionated TRT

conventional TRT