Abstract
Background
Thoracic radiotherapy (TRT) with concurrent chemotherapy is standard for limited-stage
small-cell lung cancer (LS-SCLC). However, the optimal dosing and fractionation remain
unclear. The National Comprehensive Cancer Network guidelines have recommended either
45 Gy delivered twice daily (BID) or 60 to 70 Gy delivered once daily (QD). However,
the current practice patterns among US radiation oncologists are unknown.
Materials and Methods
We surveyed US radiation oncologists using an institutional review board-approved
questionnaire. The questions covered demographic data, self-rated knowledge of key
trials, and treatment recommendations.
Results
We received 309 responses from radiation oncologists. Of the 309 radiation oncologists,
60% preferred TRT QD and 76% acknowledged QD to be more common in their practice.
The respondents in academic settings were more likely to endorse BID treatment by
both preference (P = .001) and actual practice (P = .009). The concordance between preferring QD and administering QD in practice was
100%. In contrast, 40% of respondents who preferred BID actually administered QD more
often. Also, 15% of physicians would be unwilling to switch from QD to BID and 3%
would be unwilling to switch from BID to QD, even on patient request. Most respondents
(88%) recommended a dose of 45 Gy for BID treatment. For QD treatment, the division
was greater, with 54% recommending 60 Gy, 30% recommending 63 to 66 Gy, and 10% recommending
70 Gy.
Conclusion
Substantial variation exists in how US radiation oncologists approach TRT dosing and
fractionation for LS-SCLC. Three quarters of our respondents reported administering
TRT QD most often. The most common doses were 60 Gy QD and 45 Gy BID. The results
of the present survey have provided the most up-to-date information on US practice
patterns for LS-SCLC.
Keywords
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Article Info
Publication History
Published online: August 22, 2018
Accepted:
August 11,
2018
Received in revised form:
July 24,
2018
Received:
May 6,
2018
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
