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. 2022 May;84(2):327-338.
doi: 10.18999/nagjms.84.2.327.

＜Editors' Choice＞ Elective nodal irradiation versus involved field radiotherapy for limited disease small cell lung cancer: a single-institution experience

Gen Suzuki  1 , Hideya Yamazaki  1 , Norihiro Aibe  1 , Koji Masui  1 , Daisuke Shimizu  1 , Takuya Kimoto  1 , Shinsuke Nagasawa  1 , Tadashi Takenaka  1 , Norihisa Masai  1 , Sho Watanabe  1 , Sho Seri  1 , Nagara Tamaki  1 , Koichi Takayama  2 , Kei Yamada  1
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＜Editors' Choice＞ Elective nodal irradiation versus involved field radiotherapy for limited disease small cell lung cancer: a single-institution experience

Gen Suzuki et al. Nagoya J Med Sci. 2022 May.

Abstract

Elective nodal irradiation (ENI) and involved field radiotherapy (IFRT) are definitive radiotherapeutic approaches used to treat patients with limited-disease small cell lung cancer (LD-SCLC). However, no solid consensus exists on their optimal target volume. The current study aimed to assess the clinical outcomes of patients with LD-SCLC who received definitive ENI or IFRT. A retrospective single-institution study of patients who received definitive radiotherapy between 2008 and 2020 was performed. All patients underwent whole-body positron emission tomography/computed tomography before three-dimensional conformal radiotherapy. Among the 37 patients analyzed, 22 and 15 received ENI and IFRT, respectively. The thoracic radiotherapy dose was mostly either 60 Gy in 30 fractions delivered in 2-Gy fractions once daily or 45 Gy in 30 fractions delivered in 1.5-Gy fractions twice daily. The median follow-up period was 21.4 months. A total of 12 patients (32%) experienced locoregional relapse: 10 within and 2 outside the irradiation fields. One patient in the IFRT group experienced isolated nodal failure. Differences in locoregional relapse-free, progression-free, and overall survival rates between ENI and IFRT were not significant. Overall, IFRT did not promote a significant increase in locoregional recurrence compared to ENI. Our findings suggested the utility of IFRT in standard clinical practice and support its use for patients with LD-SCLC.

Keywords: chemoradiotherapy; elective nodal irradiation; involved field radiotherapy; limited disease; small cell lung cancer.

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Conflict of interest statement

The authors declare that they have no conflicts of interest regarding this study.

Figures

Fig. 1
Fig. 1
Overall survival, progression-free survival, and locoregional relapse-free rate for patients with limited-disease small cell lung cancer treated with radiotherapy OS: overall survival LRRF: locoregional relapse free PFS: progression-free survival
Fig. 2
Fig. 2
Kaplan-Meier curves for patients treated with involved field radiotherapy (IFRT) versus elective nodal irradiation (ENI) Fig. 2A: Locoregional relapse free Fig. 2B: Overall survival Fig. 2C: Progression-free survival
See this image and copyright information in PMC

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