2024 World Conference on Lung Cancer (WCLC) - Posters-P1.13A.06 Outcomes in LS SCLC Patients with Severe Acute Esophagitis During Chemotherapy and Concurrent Twice-Daily Thoracic Radiotherapy

P1.13A.06 Outcomes in LS SCLC Patients with Severe Acute Esophagitis During Chemotherapy and Concurrent Twice-Daily Thoracic Radiotherapy

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The study investigates the impact of severe acute esophagitis on patients with limited-stage (LS) small-cell lung cancer (SCLC) undergoing chemotherapy and twice-daily thoracic radiotherapy (BID TRT). Severe esophagitis was correlated with significantly higher reports of dysphagia (difficulty swallowing), although it did not lead to increased long-term complications according to investigator reports. In analyzing the effects of radiation dose, patients receiving 60 Gy in 40 fractions did not experience more long-term dysphagia, despite the fact that those needing esophageal stents were from this group.<br /><br />The research aimed to address whether severe acute radiation-induced esophagitis influences treatment outcomes, such as progression-free survival (PFS) or overall survival (OS). Results showed no statistically significant differences in PFS or OS between patients experiencing severe esophagitis and those with mild or no esophagitis during treatment. This suggests that concerns over severe acute esophagitis should not deter the use of BID TRT regimens of 45-60 Gy for LS SCLC patients.<br /><br />The study was part of a randomized phase II trial involving 170 participants treated with four courses of platinum/etoposide, divided into groups receiving 45 Gy or 60 Gy TRT. The researchers assessed esophagitis using the CTCAE grading system, with a significant difference in dysphagia mean scores being clinical changes of 10 points or more. Most patients effectively completed their treatment without severe long-term esophagitis repercussions.<br /><br />Overall, the data supports that severe acute esophagitis during treatment should not impede the application of higher-dose BID TRT, as it does not negatively impact key survival metrics. This insight could help alleviate the concerns regarding radiotoxicity, potentially improving the implementation of twice-daily radiotherapy regimens.

Asset Subtitle

Miriam Grønberg

Meta Tag

Speaker Miriam Grønberg

Topic SCLC & Neuroendocrine Tumors

Keywords

severe acute esophagitis

limited-stage small-cell lung cancer

chemotherapy

twice-daily thoracic radiotherapy

dysphagia

progression-free survival

overall survival

radiation dose

CTCAE grading system

radiotoxicity