Higgins Kristin A, Gorgens Sophia, Sudmeier Lisa J, Faivre-Finn Corinne
Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
Department of Thoracic Oncology, University of Manchester, The Christie NHS Foundation Trust, Withington, Manchester, UK.
Transl Lung Cancer Res. 2019 Sep;8(Suppl 2):S147-S152. doi: 10.21037/tlcr.2019.05.13.
Limited stage small cell lung cancer (LS-SCLC) remains a challenging disease, with 5-year overall survival ranging from 30-35% with current standard of care treatment consisting of thoracic radiation to 45 Gy in 30 fractions delivered twice daily, with concurrent platinum/etoposide chemotherapy, followed by prophylactic cranial irradiation (PCI). The randomized, phase III CONVERT study confirmed 45 Gy delivered twice daily to be the optimal radiation fractionation regimen, without significantly increased toxicity when compared to daily radiation to 66 Gy. Immunotherapy is now being studied in addition to chemoradiation, in both the concurrent and consolidative setting. These randomized trials are ongoing. Additionally, the role of PCI compared to MRI surveillance is being evaluated in patients with LS-SCLC in both the North America and Europe. Ideally these ongoing studies will continue to improve outcomes for LS-SCLC.
局限期小细胞肺癌（LS-SCLC）仍然是一种具有挑战性的疾病，目前的标准治疗方案包括每天两次进行30次分割、总剂量达45 Gy的胸部放疗，同时联合铂类/依托泊苷化疗，随后进行预防性脑照射（PCI），其5年总生存率为30%-35%。随机III期CONVERT研究证实，每天两次给予45 Gy是最佳的放疗分割方案，与每天给予66 Gy放疗相比，毒性没有显著增加。目前正在同步和巩固治疗阶段研究免疫疗法联合放化疗的效果。这些随机试验正在进行中。此外，北美和欧洲都在评估PCI与MRI监测相比在LS-SCLC患者中的作用。理想情况下，这些正在进行的研究将继续改善LS-SCLC的治疗效果。
