ASCO Endorses Guidelines on Radiation Therapy for SCLC

Kelli Whitlock Burton

February 12, 2021

Takeaway

  • The American Society of Clinical Oncology (ASCO) has endorsed guidelines on radiation therapy (RT) for patients with small cell lung cancer (SCLC), addressing thoracic radiotherapy for limited-stage SCLC, stereotactic body radiotherapy (SBRT) for stage I-II node-negative SCLC, prophylactic cranial radiotherapy (PCI), and thoracic consolidation for extensive-stage SCLC.

Why this matters

  • ASCO's endorsement of the guidelines, originally developed by the American Society for Radiation Oncology (ASTRO) in June 2020, comes with some clarifying comments.

Key clarifications to ASTRO guidelines

  • In patients with limited-stage SCLC undergoing chemotherapy with concomitant thoracic RT, maintaining the timing of chemotherapy is critical for accelerated dose-intensive RT, including twice-daily, hyperfractionated regimens.

  • Defined ultracentral tumors as those with the planning target volume touching or overlapping the proximal bronchial tree, esophagus, or trachea.

  • PCI should remain the standard of care in limited-stage SCLC.

  • Thoracic RT to 3000 cGy in 10 fractions within 6-8 weeks of completion of chemotherapy before maintenance immunotherapy is conditionally recommended in patients with extensive-stage SCLC who respond to chemotherapy and immunotherapy and have residual disease in the thorax.

References

Daly ME, Ismaila N, Decker RH, Higgins K, Owen D, Saxena A, Franklin GE, Donaldson D, Schneider BJ. Radiation Therapy for Small-Cell Lung Cancer: ASCO Guideline Endorsement of an ASTRO Guideline. J Clin Oncol. 2021 Jan 27 [Epub ahead of print]. doi: 10.1200/JCO.20.03364. PMID: 33502911

This article originally appeared on Univadis, part of the Medscape Professional Network.

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