Topics:
Radiation Oncology • Thoracic Malignancies
What fractionation do you use for consolidative chest RT in extensive stage SCLC?
Is 30Gy/10fx from the CREST trial standard? Do you ever use a more/less protracted fractionation? Does a malignant pleural effusion at diagnosis affect your approach?
Answer from: Radiation Oncologist at Academic Institution
3 Gy x 10 is arguably the standard of care.For patients with good performance status, and who do not have extensive disease outside of the thorax (which is clearly a judgment call), we consider 2.5 Gy x 20 with a 2 week break. This is a well-tolerated schedule with respect to esophagitis. For those ...
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Answer from: Radiation Oncologist at Community Practice
45/15 to 50/20 in great PS patients with a CR, otherwise 30/10
Answer from: Radiation Oncologist at Academic Institution
I agree with Dr Milano. The best evidence is for 3 x 10, and while I frequently use that dose I also try to make a clinical judgement about the patients performance status, the extent of extrathoracic disease (pre and post chemotherapy), and the potential toxicity of treatment. For a patient w...
Answer from: Radiation Oncologist at Community Practice
The ED SCLC TRT is used sequentially in responders with residual chest disease and good performance status. In the CREST trial 30 Gy in 10 is a fine TRT for ED SCLC standard. Also, the RTOG chest plus isolated fewer than 3 distant sites study selected 45Gy in 15fx...a scheme that was tolerable, and ...