Department of Radiation Oncology, Kantonsspital St. Gallen, Switzerland.
Division of Cancer Sciences, University of Manchester & The Christie NHS Foundation Trust Manchester, United Kingdom.
Radiother Oncol. 2020 Sep;150:26-29. doi: 10.1016/j.radonc.2020.05.004. Epub 2020 May 22.
In limited disease small cell lung cancer (LD-SCLC), the CONVERT trial has not demonstrated superiority of once-daily (QD) radiotherapy (66 Gy) over twice-daily (BID) radiotherapy (45 Gy). We explored the factors influencing the selection between QD and BID regimens.
Thirteen experienced European thoracic radiation oncologists as selected by the European Society for Therapeutic Radiation Oncology (ESTRO) were asked to describe their strategies in the management of LD-SCLC. Treatment strategies were subsequently converted into decision trees and analysed for agreement and discrepancies.
Logistic reasons, patients' performance status and radiotherapy dose constraints were the three major decision criteria used by most experts in decision making. The use of QD and BID regimens was balanced among European experts, but there was a trend towards the BID regimen for fit patients able to travel twice a day to the radiotherapy site.
BID and QD radiotherapy are both accepted regimens among experts and the decision is influenced by pragmatic factors such as availability of transportation.
在局限性小细胞肺癌（LD-SCLC）中，CONVERT 试验并未显示每日一次（QD）放疗（66Gy）优于每日两次（BID）放疗（45Gy）。我们探讨了影响 QD 和 BID 方案选择的因素。
通过欧洲肿瘤放射治疗学会（ESTRO）选择了 13 名经验丰富的欧洲胸部放射肿瘤学家，要求他们描述治疗 LD-SCLC 的策略。随后将治疗策略转换为决策树，并对一致性和差异进行分析。
逻辑原因、患者的体能状态和放疗剂量限制是大多数专家在决策中使用的三个主要决策标准。QD 和 BID 方案在欧洲专家中使用平衡，但对于能够每天两次前往放疗地点的适合患者，BID 方案有使用趋势。
QD 和 BID 放疗都是专家认可的方案，决策受到交通便利性等实际因素的影响。
