Thoracic Radiotherapy in Limited-Stage SCLC—a Population-Based Study of Patterns of Care in Norway From 2000 Until 2018
Gustav Graabak, Bjørn Henning Grønberg, Marie Søfteland Sandvei, Yngvar Nilssen, Tarje Onsøien Halvorsen
Abstract
INTRODUCTION: Twice-daily (BID) thoracic radiotherapy (TRT) of 45 Gy per 30 fractions is recommended for limited-stage (LS) SCLC, but most patients are treated with once-daily (OD) schedules owing to toxicity concerns and logistic challenges. An alternative is hypofractionated OD TRT of 40 to 42 Gy per 15 fractions. A randomized trial by our group indicated that TRT of 45 Gy per 30 fractions is more effective than TRT of 42 Gy per 15 fractions, and because it was not more toxic, 45 BID replaced 42 OD as the recommended schedule in Norway. The aims of this study were to evaluate to what extent BID TRT has been implemented in Norway and whether this practice change has led to improved survival. METHODS: Data on all patients diagnosed with LS SCLC from 2000 until 2018 were collected from the Cancer Registry of Norway, containing nearly complete data on cancer diagnosis, radiotherapy, and survival. RESULTS: = 0.0015). CONCLUSIONS: = 0.0023) and clinically relevant survival improvement.