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Lung Cancer • Radiation Oncology • Thoracic Malignancies • Medical Oncology • NCI-CCC Tumor Board Question • Small cell lung cancer • Vanderbilt • NCI-CCC Thoracic Tumor Board Question
As consolidative thoracic radiation (cTRT) was prohibited on the seminal chemoimmunotherapy trials in ES-SCLC, how do you approach cTRT in practice?
Would you consider it for a patient who had bulky thoracic disease, only a single extrathoracic site of involvement and achieved a CR after induction chemoimmunotherapy?
Answer from: Radiation Oncologist at Community Practice
There are two trials showing benefit for TRT for patients with ES-SCLC, one from Yugoslavia and one from the EORTC (though, the primary endpoint was not met). The Yugoslavian trial was not considered practice changing, while the EORTC study has made me consider adding TRT in certain patients, even w...
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Answer from: Medical Oncologist at Academic Institution
I approach this on a case-by-case basis. If a patient has had a good response to induction chemoimmunotherapy and had bulky thoracic disease at presentation, it is reasonable for the patient and radiation oncology team to consider cTRT.