Stereotactic Body Radiotherapy (SBRT) in Very Limited-Stage Small Cell Lung Cancer (VLS-SCLC)

Small cell lung cancer (SCLC) is an aggressive neuroendocrine tumour with metastatic propensity. Stereotactic body radiation therapy (SBRT) is an emerging therapeutic option for SCLC, despite limited supporting evidence. By evaluating the use of SBRT in very limited stage (VLS) SCLC at our institution, we aimed to contribute to the existing knowledge in this area while establishing a basis for further research. We performed a retrospective review of all cases of VLS-SCLC treated with SBRT between 2013 and 2020. Baseline demographics, diagnostic, and treatment information were collected. The primary outcome was overall survival (OS). We identified 46 patients with pathologically confirmed VLS-SCLC; 25 were treated with SBRT, and the remainder received either surgery, conventional radiation therapy, chemotherapy, or palliative-intent therapy. After a median follow-up of 23.7 months, 44% of the patients had died; the median OS was of 24.4 months for the SBRT cohort and 67.0 months for the curative intent non-SBRT cohort. The difference in disease recurrence and survival between cohorts was underpowered and not statistically significant. Higher baseline ECOG and comorbidity was noted in the SBRT cohort.

[1]  P. Wheatley‐Price,et al.  EP03.01-016 The Canadian Small Cell Lung Cancer Database (CASCADE): Results from a Multi-Institutional Real-World Evidence Collaboration , 2022, Journal of Thoracic Oncology.

[2]  A. Louie,et al.  Stereotactic ablative radiotherapy in T1-2N0M0 small cell lung cancer: A systematic review and meta-analysis. , 2021, Lung cancer.

[3]  C. Rudin,et al.  Small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. , 2021, Annals of oncology : official journal of the European Society for Medical Oncology.

[4]  J. Belda-Sanchís,et al.  The current role of surgery and SBRT in early stage of small cell lung cancer , 2021, Journal of clinical and translational research.

[5]  A. Louie,et al.  Current Management and Progress in Radiotherapy for Small Cell Lung Cancer , 2020, Frontiers in Oncology.

[6]  K. Rosenzweig,et al.  Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline. , 2020, Practical radiation oncology.

[7]  V. Verma,et al.  Stereotactic ablative radiation therapy versus conventionally fractionated radiation therapy for stage I small cell lung cancer. , 2019, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[8]  B. Slotman,et al.  The evolving role of radiotherapy in the management of small cell lung cancer. , 2018, Journal of thoracic disease.

[9]  Y. Shibamoto,et al.  Clinical Outcomes of Stereotactic Body Radiotherapy for Patients With Stage I Small-Cell Lung Cancer: Analysis of a Subset of the Japanese Radiological Society Multi-Institutional SBRT Study Group Database , 2018, Technology in cancer research & treatment.

[10]  M. Delgado-Rodríguez,et al.  Systematic review and meta-analysis. , 2017, Medicina intensiva.

[11]  C. Simone,et al.  Outcomes of Stereotactic Body Radiotherapy for T1‐T2N0 Small Cell Carcinoma According to Addition of Chemotherapy and Prophylactic Cranial Irradiation: A Multicenter Analysis , 2017, Clinical lung cancer.

[12]  B. Loo,et al.  Optimal Radiation Therapy for Small Cell Lung Cancer , 2017, Current Treatment Options in Oncology.

[13]  M. Tonelli,et al.  Recommendations on screening for lung cancer , 2016, Canadian Medical Association Journal.

[14]  C. Simone,et al.  Stereotactic Radiotherapy for Stage I Small Cell Lung Cancer , 2016, The oncologist.

[15]  G. Videtic The Role of Radiotherapy in Small Cell Lung Cancer: a Revisit , 2015, Current Oncology Reports.

[16]  Peter Balter,et al.  Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials. , 2015, The Lancet. Oncology.

[17]  Dong Wang,et al.  Stereotactic body radiotherapy with concurrent chemotherapy extends survival of patients with limited stage small cell lung cancer: a single-center prospective phase II study , 2014, Medical Oncology.

[18]  Steven H. Lin,et al.  Stereotactic body radiation therapy for stage I small cell lung cancer: a single institutional case series and review of the literature , 2014, Journal of Radiation Oncology.

[19]  C. Reddy,et al.  Stereotactic body radiation therapy-based treatment model for stage I medically inoperable small cell lung cancer. , 2013, Practical radiation oncology.

[20]  Hiroshi Honda,et al.  Clinical results of stereotactic body radiotherapy for Stage I small-cell lung cancer: a single institutional experience , 2010, Journal of radiation research.

[21]  J. Hengstler,et al.  Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer--what limits limited disease? , 2002, Lung cancer.

[22]  F. V. von Eyben Treating small cell lung cancer. , 1992, BMJ.

[23]  H. Hansen,et al.  Lung cancer. , 1990, Cancer chemotherapy and biological response modifiers.