Is stereotactic radiotherapy alone an option for SCLC?

  • Rusthoven CG & al.
  • JAMA Oncol
  • 04.06.2020

  • von Kelli Whitlock Burton
  • Studien – kurz & knapp
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Takeaway

  • Patients with small-cell lung cancer (SCLC) and brain metastases treated with firstline stereotactic radiosurgery (SRS) alone had significantly better OS than those who received whole-brain radiotherapy (WBRT).
  • However, they had worse time to central nervous system (CNS) progression (TTCP) in this cohort study.

Why this matters

  • Although WBRT is standard therapy for SCLC with brain metastases, SRS alone may be appropriate for select patients.

Study design

  • International, multicenter FIRE-SCLC cohort study.
  • 710 patients with SCLC and brain metastases treated with firstline SRS and 219 patients treated with firstline WBRT.
  • Funding: University of Colorado Cancer Center.

Key results

  • Median OS was significantly better (P<.001 with brain metastasis vs>
  • 1 lesion: 11.0 months.
  • 2-4 lesions: 8.7 months. 
  • 5-10 lesions: 8.0 months. 
  • ≥11 lesions: 5.5 months.
  • Median TTCP also was significantly better (P<.001 with metastasis vs>
  • 1 lesion: 11.7 months.
  • 2-4 lesions: 6.8 months.
  • 5-10 lesions: 6.1 months. 
  • ≥11 lesions: 4.7 months.
  • SRS offered significantly better OS compared with WBRT after multivariable analysis (adjusted HR, 1.48; P<.001 and propensity matching vs months p=".003).</li">
  • WBRT yielded significantly better TTCP than SRS after multivariable analysis (adjusted HR, 0.38; P<.001 and propensity matching p>

    Limitations

    • Retrospective.