title: Clinical trial of post-chemotherapy consolidation thoracic radiotherapy for extensive-stage small cell lung cancer.
abstract: OBJECTIVE
  To define the rate of development of symptomatic chest failures in extensive stage small cell lung cancer (ES-SCLC) after undergoing post-chemotherapy chest radiotherapy (RT).
  
  
  METHODS
  Patients had ES-SCLC, attained an objective response to chemotherapy and signed study consent. Target accrual was 33 patients. Patients were offered prophylactic cranial irradiation (PCI) as per department policy. PCI (25 Gy/10 fractions) and chest RT (40 Gy/15 fractions) were given simultaneously 4-8 weeks after chemotherapy completion. Thoracic target volume was the post-chemotherapy residual chest disease plus margin. Patients were evaluated for RT toxicities, local control, disease-free and overall survival.
  
  
  RESULTS
  Thirty-two patients were evaluable. Twenty-nine patients completed RT without delay. There were 4 complete responses and 28 partial responses to chemotherapy. All study patients received PCI. Maximal acute RT toxicity was grade 2 esophagitis (18 patients). There were no RT-related deaths. Median time to disease progression and overall survival were 4.2 and 8.3 months, respectively (median follow-up=21.8 months). Of 16 chest recurrences, 7 were in the irradiated region and 5 were symptomatic.
  
  
  CONCLUSIONS
  Post-chemotherapy consolidation chest RT for ES-SCLC patients on this trial was well tolerated and associated with symptomatic chest recurrences in only 5/32 treated patients.
authors.affiliation: Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada. dony@ualberta.ca
authors.forename: Don
authors.initials: D
authors.lastname: Yee
authors.forename: Charles
authors.initials: C
authors.lastname: Butts
authors.forename: Anthony
authors.initials: A
authors.lastname: Reiman
authors.forename: Anil
authors.initials: A
authors.lastname: Joy
authors.forename: Michael
authors.initials: M
authors.lastname: Smylie
authors.forename: David
authors.initials: D
authors.lastname: Fenton
authors.forename: Quincy
authors.initials: Q
authors.lastname: Chu
authors.forename: John
authors.initials: J
authors.lastname: Hanson
authors.forename: Wilson
authors.initials: W
authors.lastname: Roa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000517:prevention & control / Q000556:secondary; D016190:Carboplatin / Q000008:administration & dosage; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D018450:Disease Progression; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D002945:Cisplatin