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More opportunity to tailor lung cancer radiotherapy

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Having radiotherapy twice a day rather than once halves treatment time and is equally good at treating small cell lung cancer, according to UK researchers.

They found radiotherapy once a day for six and a half weeks or twice a day for three weeks was equally effective at treating small cell lung cancer that has not spread.

“Our results have already begun to change practice around the world”

Corinne Faivre-Finn

The results provide more opportunity for patients and clinicians to choose together which treatment regimen suits them best, said the study researchers.

The CONVERT trial, which was funded by Cancer Research UK, investigated the best way of giving radiotherapy alongside chemotherapy for patients with small cell lung cancer.

Around 550 patients received radiotherapy either twice a day over three weeks or once a day at a higher dose over six and a half weeks. All trial participants also received chemotherapy.

Along with others in France, Spain, Belgium, Netherlands, Poland, Slovenia and Canada, researchers from the University of Manchester and the The Christie NHS Foundation Trust compared survival and side effects.

They found survival in both groups was similar, with 56% of patients who had radiotherapy twice a day surviving for two years compared with 51% of those given it once a day.

They also highlighted that the majority of side effects were similar in both groups. The exception was neutropenia, which happened more often in the twice daily treatment group – 74% versus 65%.

The trial results support the use of either once daily or twice daily radiotherapy with chemotherapy as standard treatment for small cell lung cancer that has not spread, said the researchers.

As a result, they suggested patient treatment could be planned according to what works best for both the individual and their hospital.

They added that, previously, there was no agreed dose for giving radiotherapy once or twice a day, but the CONVERT trial had identified the best amounts as 66 grays and 45 grays, respectively.

Although the trial will still be followed up for the full five years, the researchers claimed their results had already started to have an impact on clinical practice.

The Christie NHS Foundation Trust

More opportunity to tailor lung cancer radiotherapy

Corinne Faivre-Finn

Professor Corinne Faivre-Finn, trial lead in Manchester, said: “Our results have already begun to change practice around the world.

“Based on our findings, small cell lung cancer patients will be able to choose between a shorter course of radiotherapy given twice a day and a longer course given once a day,” she said.

Dr Ian Walker, Cancer Research UK’s director of clinical research, added: “Finding the most appropriate way to give treatments like radiotherapy is a crucial part of treating cancer. Before this study began there had been few large clinical trials of this type in small cell lung cancer.”

Results from the trial were presented at the American Society of Clinical Oncology’s annual conference in Chicago on Sunday.

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