Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline

被引：139

作者：

Simone, Charles B., II ^{[1
]}

Bogart, Jeffrey A. ^{[2
]}

Cabrera, Alvin R. ^{[3
]}

Daly, Megan E. ^{[4
]}

DeNunzio, Nicholas J. ^{[5
]}

Detterbeck, Frank ^{[6
]}

Faivre-Finn, Corinne ^{[7
,8
]}

Gatschet, Nancy

Gore, Elizabeth ^{[9
]}

Jabbour, Salma K. ^{[10
]}

Kruser, Tim J. ^{[11
]}

Schneider, Bryan J. ^{[12
]}

Slotman, Ben ^{[13
]}

Turrisi, Andrew ^{[14
]}

Wu, Abraham J. ^{[15
]}

Zeng, Jing ^{[16
]}

Rosenzweig, Kenneth E. ^{[17
]}

机构：

[1] New York Proton Ctr, New York, NY USA

[2] SUNY Upstate Med Univ, Dept Radiat Oncol, Syracuse, NY 13210 USA

[3] Kaiser Permanente, Dept Radiat Oncol, Seattle, WA USA

[4] Univ Calif Davis, Dept Radiat Oncol, Sacramento, CA 95817 USA

[5] Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USA

[6] Yale Univ, Sch Med, Dept Thorac Surg, New Haven, CT USA

[7] Univ Manchester, Manchester, Lancs, England

[8] Christie NHS Fdn Trust, Div Canc Sci, Manchester, Lancs, England

[9] Med Coll Wisconsin, Dept Radiat Oncol, Milwaukee, WI 53226 USA

[10] Rutgers State Univ, Dept Radiat Oncol, New Brunswick, NJ USA

[11] Northwestern Mem Hosp, Dept Radiat Oncol, Chicago, IL USA

[12] Univ Michigan, Dept Med Oncol, Ann Arbor, MI 48109 USA

[13] Vrije Univ Amsterdam Med Ctr, Dept Radiat Oncol, Amsterdam, Netherlands

[14] James H Quillen VA Med Ctr, Dept Radiat Oncol, Mountain Home, TN USA

[15] Mem Sloan Kettering, Dept Radiat Oncol, New York, NY USA

[16] Univ Washington, Dept Radiat Oncol, Seattle, WA 98195 USA

[17] Mt Sinai Med Ctr, Dept Radiat Oncol, New York, NY 10029 USA

来源：

PRACTICAL RADIATION ONCOLOGY | 2020年 / 10卷 / 03期

关键词：

PROPHYLACTIC CRANIAL IRRADIATION; PHASE-III TRIAL; DAILY THORACIC RADIOTHERAPY; LEUKEMIA GROUP-B; ELECTIVE NODAL IRRADIATION; COMBINED-MODALITY THERAPY; QUALITY-OF-LIFE; LIMITED-STAGE; RTOG; 0212; CHEST RADIOTHERAPY;

D O I：

10.1016/j.prro.2020.02.009

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Several sentinel phase III randomized trials have recently been published challenging traditional radiation therapy (RT) practices for small cell lung cancer (SCLC). This American Society for Radiation Oncology guideline reviews the evidence for thoracic RT and prophylactic cranial irradiation (PCI) for both limited-stage (LS) and extensive-stage (ES) SCLC. Methods: The American Society for Radiation Oncology convened a task force to address 4 key questions focused on indications, dose fractionation, techniques and timing of thoracic RT for LS-SCLC, the role of stereotactic body radiation therapy (SBRT) compared with conventional RT in stage I or II node negative SCLC, PCI for LS-SCLC and ES-SCLC, and thoracic consolidation for ES-SCLC. Recommendations were based on a systematic literature review and created using a consensus-building methodology and system for grading evidence quality and recommendation strength. Results: The task force strongly recommends definitive thoracic RT administered once or twice daily early in the course of treatment for LS-SCLC. Adjuvant RT is conditionally recommended in surgically resected patients with positive margins or nodal metastases. Involved field RT delivered using conformal advanced treatment modalities to postchemotherapy volumes is also strongly recommended. For patients with stage I or II node negative disease, SBRT or conventional fractionation is strongly recommended, and chemotherapy should be delivered before or after SBRT. In LS-SCLC, PCI is strongly recommended for stage II or III patients who responded to chemoradiation, conditionally not recommended for stage I patients, and should be a shared decision for patients at higher risk of neurocognitive toxicities. In ES-SCLC, radiation oncologist consultation for consideration of PCI versus magnetic resonance surveillance is strongly recommended. Lastly, the use of thoracic RT is strongly recommended in select patients with ES-SCLC after chemotherapy treatment, including a conditional recommendation in those responding to chemotherapy and immunotherapy. Conclusions: RT plays a vital role in both LS-SCLC and ES-SCLC. These guidelines inform best clinical practices for local therapy in SCLC. (C) 2020 Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.

引用

页码：158 / 173

页数：16

共 110 条

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