High-Dose Twice-Daily Thoracic Radiotherapy for Limited-Stage Small-Cell Lung Cancer: A Real-World Retrospective...

Area of Science:

• Oncology
• Radiation Oncology
• Thoracic Oncology

Background:

• Hyperfractionated thoracic radiotherapy (RT) is a standard curative treatment for limited-stage small-cell lung cancer (LS-SCLC).
• The validated regimen is 45 Gy in 30 twice-daily fractions.
• Recent data suggest dose-escalated RT (60 Gy in 40 fractions) may improve outcomes, but real-world data are scarce.

Purpose of the Study:

• To evaluate the feasibility, safety, and efficacy of dose-escalated (60 Gy) twice-daily thoracic radiotherapy in LS-SCLC patients.
• To assess overall survival (OS), progression-free survival (PFS), patterns of failure, and treatment-related toxicity.

Main Methods:

• Retrospective cohort study of LS-SCLC patients treated with 60 Gy in 40 twice-daily fractions and concurrent platinum-etoposide chemotherapy.
• Utilized modern radiation techniques at two tertiary centers.
• Analyzed outcomes including OS, PFS, failure patterns, and toxicity.

Main Results:

• Thirteen patients were analyzed (median age 59, 61.5% female).
• At 15 months median follow-up, 2-year OS rate was 71.4% (median OS 30.9 months).
• Overall response rate was 60%; most failures were distant. Grade ≥3 esophagitis occurred in 7.6%, with no grade ≥2 pneumonitis. Hematologic toxicity was manageable.

Conclusions:

• Dose-escalated twice-daily thoracic radiotherapy (60 Gy) is feasible with acceptable toxicity in routine LS-SCLC clinical practice.
• Survival outcomes appear comparable to Phase II study results.
• Larger, multi-institutional studies are warranted to confirm these findings.