Radiation Therapy for Small Cell Lung Cancer
Publication Date: March 1, 2020
Last Updated: March 14, 2022
Recommendations
Thoracic RT for limited-stage SCLC
For patients with LS-SCLC who can tolerate definitive therapy, thoracic RT is recommended. (Strong, High)
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For patients with LS-SCLC receiving chemotherapy and RT, thoracic RT should begin with cycle 1 or 2 of chemotherapy. (Strong, Moderate)
- Implementation Remark: It is important to maintain the dosage and timing of chemotherapy with RT based on trial data. Timing is more critical for accelerated dose-intensive RT.
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For postoperative patients with LS-SCLC and R1 or R2 resection, postoperative RT is conditionally recommended. (Conditional, Expert Opinion)
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For postoperative patients with LS-SCLC that is clinically node negative and pathologically N2-positive, mediastinal RT is conditionally recommended. (Conditional, Expert Opinion)
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For patients with LS-SCLC, twice-daily RT in 150 cGy fractions to 4500 cGy is recommended. (Strong, High)
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For patients with LS-SCLC, daily RT in 200 cGy fractions to 6000-7000 cGy is conditionally recommended as an acceptable alternative to twice-daily RT. (Conditional, Moderate)
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For patients with LS-SCLC, involved field RT is recommended as the standard of care (defined as fluorodeoxyglucose avid on PET, enlarged on CT, and/or biopsy-positive). (Strong, Moderate)
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For tumors that experience shrinkage with chemotherapy in patients with LS-SCLC, treating all involved nodal stations (at time of diagnosis) and postchemotherapy lung parenchymal tumor is recommended. (Strong, Moderate)
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For patients with LS-SCLC, highly conformal techniques are recommended to minimize normal tissue dose. (Strong, Low)
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Overview
Title
Radiation Therapy for Small Cell Lung Cancer
Authoring Organization
American Society for Radiation Oncology