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Article

Management of Small-Cell Lung Cancer with Radiotherapy—A Pan-Canadian Survey of Radiation Oncologists

1
Department of Oncology, McMaster University, Hamilton, ON, Canada
2
Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, ON, Canada
3
Department of Oncology, University of Edmonton, Edmonton, AB, Canada
4
Cross Cancer Institute at Alberta Health Services, Edmonton, AB, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2016, 23(3), 184-195; https://doi.org/10.3747/co.23.3023
Submission received: 8 March 2016 / Revised: 6 April 2016 / Accepted: 5 May 2016 / Published: 1 June 2016

Abstract

Background: The management of small-cell lung cancer (SCLC) with radiotherapy (RT) varies, with many treatment regimens having been described in the literature. We created a survey to assess patterns of practice and clinical decision-making in the management of SCLC by Canadian radiation oncologists (ROS). Methods: A 35-item survey was sent by e-mail to Canadian ROS. The questions investigated the role of RT, the dose and timing of RT, target delineation, and use of prophylactic cranial irradiation (PCI) in limited-stage (LS) and extensive-stage (ES) SCLC. Results: Responses were received from 52 eligible ROS. For LS-SCLC, staging (98%) and simulation or dosimetric (96%) computed tomography imaging were key determinants of RT suitability. The most common dose and fractionation schedule was 40–45 Gy in 15 once-daily fractions (40%), with elective nodal irradiation performed by 31% of ROS. Preferred management of clinical T1/2aN0 SCLC favoured primary chemoradiotherapy (64%). For ES-SCLC, consolidative thoracic RT was frequently offered (88%), with a preferred dose and fractionation schedule of 30 Gy in 10 once-daily fractions (70%). Extrathoracic consolidative RT would not be offered by 23 ROS (44%). Prophylactic cranial irradiation was generally offered in LS-SCLC (100%) and ES-SCLC (98%) after response to initial treatment. Performance status, baseline cognition, and pre-PCI brain imaging were important patient factors assessed before an offer of PCI. Conclusions: Canadian ROS show practice variation in SCLC management. Future clinical trials and national treatment guidelines might reduce variability in the treatment of early-stage disease, optimization of dose and targeting in LS-SCLC, and definition of suitability for PCI or consolidative RT.
Keywords: small-cell lung cancer; radiotherapy; radiation; SCLC small-cell lung cancer; radiotherapy; radiation; SCLC

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MDPI and ACS Style

Shahi, J.; Wright, J.R.; Gabos, Z.; Swaminath, A. Management of Small-Cell Lung Cancer with Radiotherapy—A Pan-Canadian Survey of Radiation Oncologists. Curr. Oncol. 2016, 23, 184-195. https://doi.org/10.3747/co.23.3023

AMA Style

Shahi J, Wright JR, Gabos Z, Swaminath A. Management of Small-Cell Lung Cancer with Radiotherapy—A Pan-Canadian Survey of Radiation Oncologists. Current Oncology. 2016; 23(3):184-195. https://doi.org/10.3747/co.23.3023

Chicago/Turabian Style

Shahi, J., J.R. Wright, Z. Gabos, and A. Swaminath. 2016. "Management of Small-Cell Lung Cancer with Radiotherapy—A Pan-Canadian Survey of Radiation Oncologists" Current Oncology 23, no. 3: 184-195. https://doi.org/10.3747/co.23.3023

APA Style

Shahi, J., Wright, J. R., Gabos, Z., & Swaminath, A. (2016). Management of Small-Cell Lung Cancer with Radiotherapy—A Pan-Canadian Survey of Radiation Oncologists. Current Oncology, 23(3), 184-195. https://doi.org/10.3747/co.23.3023

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