SBRT on par with HART in limited-stage small-cell lung cancer

Stereotactic body radiotherapy (SBRT) is a safe and effective alternative to hyperfractionated accelerated radiotherapy (HART) in the treatment of limited-stage small-cell lung cancer (LS-SCLC), suggests a recent study.

The authors retrospectively divided 188 patients with LS-SCLC into two groups receiving chemotherapy combined with either SBRT or HART. In the HART group, patients received 4,500 cGy in 30 fractions, administered twice daily for 3 weeks. In the SBRT group, participants received 4,000‒4,500 cGy in 10 fractions over 2 weeks. Thirty-three pairs of patients were included in the subsequent analysis.

The estimated objective response rate was 63.6 percent (21/33) with HART and 78.8 percent (26/33) with SBRT (p=0.269). No significant between-group difference was noted in overall survival (26 months vs 29 months; p=0.362) and progression-free survival (11 vs 15 months; p=0.223).

In terms of safety, toxicity is similar between SBRT and HART, with no grade 4 event occurring in either group. However, grade 3 pneumonitis cases occurred in the HART group (9.1 percent; 3/33; p=0.238) and grade 3 esophagitis in the SBRT group (6.1 percent; 2/33; p=0.492).

“Compared with HART, SBRT could be another effective treatment with satisfactory safety for the concurrent chemoradiotherapy in patients with LS-SCLC,” the authors said.

“Concurrent chemoradiotherapy based on HART is the first-line recommended regimen for the treatment of SCLC, [but] SBRT is also regarded as an effective treatment for LS-SCLC,” they noted.