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The Radiation Target in Small-Cell Lung Cancer

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Advances in Radiation Oncology in Lung Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Abstract

What constitutes the appropriate target in the treatment of small-cell lung cancer is an area of active investigation. Advances in the last 30 years in radiologic and nuclear imaging as well as in radiotherapy delivery have prompted revision of the classically defined target which was designed to be “tolerable” and encompass visible tumor and potential areas of microscopic disease. Current trends are to minimize normal tissue irradiation and more precisely define the extent of potential microscopic spread in order to optimize target volume. This chapter will review historic trials and ongoing studies to provide a comprehensive understanding on the evolution of the radiotherapy target in small-cell lung cancer.

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References

  • Aristei C, Falcinelli L, Palumbo B, Tarducci R (2010) PET and PET-CT in radiation treatment planning for lung cancer. Expert Rev Antic Ther 10:571–584

    Article  CAS  Google Scholar 

  • Arriagada R, Pellae-Cosset B, Ladron de Guevara JC, el Bakry H, Benna F, Martin M, de Cremoux H, Baldeyrou P, Cerrina ML, Le Chevalier T (1991) Alternating radiotherapy and chemotherapy schedules in limited small cell lung cancer: analysis of local chest recurrences. Radiother Oncol 20:91–98

    Article  PubMed  CAS  Google Scholar 

  • Auperin A, Arriagada R, Pignon JP, Le Pechoux C, Gregor A, Stephens RJ et al (1999) Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic cranial irradiation overview collaborative group. N Engl J Med 341:476–484

    Article  PubMed  CAS  Google Scholar 

  • Baas P, Belderbos JS, Senan S, Kwa HB, van Bochove A, van Tinteren H, Burgers JA, van Meerbeeck JP (2006) Concurrent chemotherapy (carboplatin, paclitaxel, etoposide) and involved-field radiotherapy in limited stage small cell lung cancer: a Dutch multicenter phase II study. Br J Cancer 94:625–630

    PubMed  CAS  Google Scholar 

  • Belderbos J, Baas P, Senan S (2007) Reply: patterns of nodal recurrence after omission of elective nodal irradiation for limited-stage small-cell lung cancer. British J Cancer 97:276

    Article  Google Scholar 

  • Bleehen NM, Bunn PA, Cox JD, Dombernowsky P, Fox RM, Høst H, Joss R, White JE, Wittes RE (1983) Role of radiation therapy in small cell anaplastic carcinoma of the lung. Cancer Treat Rep 67:11–19

    PubMed  CAS  Google Scholar 

  • Bogart JA, Herndon JE 2nd, Lyss AP, Watson D, Miller AA, Lee ME, Turrisi AT, Green MR, Cancer and Leukemia Group B study 39808 (2004) 70 Gy thoracic radiotherapy is feasible concurrent with chemotherapy for limited-stage small-cell lung cancer: analysis of cancer and leukemia group B study 39808. Int J Radiat Oncol Biol Phys 59:460–468

    Article  PubMed  CAS  Google Scholar 

  • Bradley JD, Dehdashti F, Mintun MA, Govindan R, Trinkaus K, Siegel BA (2004) Positron emission tomography in limited-stage small-cell lung cancer: a prospective study. J Clin Oncol 22:3248–3254

    Article  PubMed  Google Scholar 

  • Brodin O, Rikner G, Steinholtz L, Nou E (1990) Local failure in patients treated with radiotherapy and multidrug chemotherapy for small cell lung cancer. Acta Oncol 29:739–746

    Article  PubMed  CAS  Google Scholar 

  • Bunn PA Jr, Lichter AS, Makuch RW, Cohen MH, Veach SR, Matthews MJ, Anderson AJ, Edison M, Glatstein E, Minna JD et al (1987) Chemotherapy alone or chemotherapy with chest radiation therapy in limited stage small cell lung cancer. A prospective, randomized trial. Ann Intern Med 106:655–662

    Article  PubMed  Google Scholar 

  • Cooper S, Spiro SG (2006) Small cell lung cancer: treatment review. Respirology 11:241–248

    Article  PubMed  Google Scholar 

  • Curran WJ Jr (2001) Therapy of limited stage small cell lung cancer. Cancer Treat Res 105:229–252

    Article  PubMed  Google Scholar 

  • de Ruysscher D, Vansteenkiste J (2000) Chest radiotherapy in limited-stage small cell lung cancer: facts, questions, prospects. Radiother Oncol 55:1–9

    Article  PubMed  Google Scholar 

  • de Ruysscher D, Bremer RH, Koppe F, Wanders S, van Haren E, Hochstenbag M, Geeraedts W, Pitz C, Simons J, ten Velde G, Dohmen J, Snoep G, Boersma L, Verschueren T, van Baardwijk A, Dehing C, Pijls M, Minken A, Lambin P (2006) Omission of elective node irradiation on basis of CT-scans in patients with limited disease small cell lung cancer: a phase II trial. Radiother Oncol 80:307–312

    Article  PubMed  Google Scholar 

  • Emami B (1996) Three-dimensional conformal radiation therapy in bronchogenic carcinoma. Semin Radiat Oncol 6:92–97

    Article  PubMed  Google Scholar 

  • European Organisation for Research and Treatment of Cancer (EORTC) trial (2007) A randomized controlled trial of concurrent chemo-radiotherapy comparing twice-daily and once-daily radiotherapy schedules in patients with limited stage small celllung cancer (SCLC) and good performance status. http://www.christie.nhs.uk/research/themes/convert/default.aspx. Accessed 13 Mar 2011

  • Faivre-Finn C, Lee LW, Lorigan P, West C, Thatcher N (2005a) Thoracic radiotherapy forlimited-stage small-cell lung cancer: controversies and future developments. Clin Oncol (R Coll Radiol) 17:591–598

    Article  CAS  Google Scholar 

  • Faivre-Finn C, Lorigan P, West C, Thatcher N (2005b) Thoracic radiation therapy for limited-stage small-cell lung cancer: unanswered questions. Clin Lung Cancer 7:23–29

    Article  PubMed  Google Scholar 

  • Fried DB, Morris DE, Poole C, Rosenman JG, Halle JS, Detterbeck FC, Hensing TA, Socinski MA (2004) Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer. J Clin Oncol 22:4785–4793

    Article  Google Scholar 

  • Huncharek M, McGarry R (2004) A meta-analysis of the timing of chest irradiation in the combined modality treatment of limited-stage small cell lung cancer. Oncologist 9:6665–6672

    Article  Google Scholar 

  • International Commission on Radiation Units and Measurements (1993) Prescribing, recording, and reporting photon beam therapy, ICRU Report 50, MD, USA

    Google Scholar 

  • International Commission on Radiation Units and Measurements (1999) Prescribing, recording, and reporting photon beam therapy (Supplement to ICRU Report 50). ICRU Report 62, MD, USA

    Google Scholar 

  • Jeremic B (2006) Timing of concurrent radiotherapy and chemotherapy in limited-disease small-cell lung cancer: “Meta-analysis of meta-analyses”. Int J Radiat Oncol Biol Phys 64:981–982

    Article  PubMed  Google Scholar 

  • Jeremic B, Shibamoto Y, Acimovic L, Milisavljevic S (1997) Initial versus delayed accelerated hyperfractionated radiation therapy and concurrent chemotherapy in limited small-cell lung cancer: a randomized study. J Clin Oncol 15:893–900

    PubMed  CAS  Google Scholar 

  • Jeremic B, Shibamoto Y, Nikolic N, Milicic B, Milisavljevic S, Dagovic A, Aleksandrovic J, Radosavljevic-Asic G (1999) Role of radiation therapy in the combined-modality treatment of patients with extensive disease small-cell lung cancer: a randomized study. J Clin Oncol 17:2092–2099

    PubMed  CAS  Google Scholar 

  • Kamel EM, Zwahlen D, Wyss MT, Stumpe KD, von Schulthess GK, Steinert HC (2003) Whole-body (18) F-FDG PET improves the management of patients with small cell lung cancer. J Nucl Med 44:1911–1917

    PubMed  Google Scholar 

  • Kies MS, Mira JG, Crowley JJ, Chen TT, Pazdur R, Grozea PN, Rivkin SE, Coltman CA Jr, Ward JH, Livingston RB (1987) Multimodal therapy for limited small-cell lung cancer: a randomized study of induction combination chemotherapy with or without thoracic radiation in complete responders; and with wide-field versus reduced-field radiation in partial responders: a southwest oncology group study. J Clin Oncol 5:592–600

    PubMed  CAS  Google Scholar 

  • Kong FM, Gaspar LE, Komaki R, Sun A, Bonner JA, Choy H, Wang L, Morris D, Sandler HM, Movsas B (2007) Patterns of practice in radiation dose prescription and treatment planning for patients with lung cancer among members of American society of therapeutic radiology and oncology. Int J Radiat Oncol Biol Phys 69(Suppl 1):S483

    Article  Google Scholar 

  • Lee CB, Morris DE, Fried DB et al (2006) Current and evolving treatment options for limited stage small cell lung cancer. Curr Opin Oncol 18:162–172

    Article  PubMed  Google Scholar 

  • Liengswangwong V, Bonner JA, Shaw EG, Foote RL, Frytak S, Eagan RT, Jett JR, Richardson RL, Creagan ET, Su JQ (1994) Limited-stage small-cell lung cancer: patterns of intrathoracic recurrence and the implications for thoracic radiotherapy. J Clin Oncol 12:496–502

    PubMed  CAS  Google Scholar 

  • Mira JG, Livingston RB (1980) Evaluation and radiotherapy implications of chest relapse patterns in small cell lung carcinoma treated with radiotherapy-chemotherapy: study of 34 cases and review of the literature. Cancer 46:2557–2565

    Article  PubMed  CAS  Google Scholar 

  • Mira JG, Livingston RB, Moore TN, Chen T, Batley F, Bogardus CR Jr, Considine B Jr, Mansfield CM, Schlosser J, Seydel HG (1982) Influence of chest radiotherapy in frequency and patterns of chest relapse in disseminated small cell lung carcinoma. A southwest oncology group study. Cancer 50:1266–1272

    Article  PubMed  CAS  Google Scholar 

  • Murray N, Coy P, Pater JL, Hodson I, Arnold A, Zee BC, Payne D, Kostashuk EC, Evans WK, Dixon P et al (1993) Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The national cancer institute of Canada clinical trials group. J Clin Oncol 11:336–344

    PubMed  CAS  Google Scholar 

  • Perez CA, Krauss S, Bartolucci AA, Durant JR, Lowenbraun S, Salter MM, Storaalsi J, Kellermeyer R, Comas F (1981) Thoracic and elective brain irradiation with concomitant or delayed multiagent chemotherapy in the treatment of localized small cell carcinoma of the lung: a randomized prospective study by the southeastern cancer study group. Cancer 47:2407–2413

    Article  PubMed  CAS  Google Scholar 

  • Perez CA, Einhorn L, Oldham RK, Greco FA, Cohen HJ, Silberman H, Krauss S, Hornback N, Comas F, Omura G, et al (1984) Randomized trial of radiotherapy to the thorax in limited small-cell carcinoma of the lung treated with multiagent chemotherapy and elective brain irradiation: a preliminary report. J Clin Oncol 2:1200–1208

    PubMed  CAS  Google Scholar 

  • Perry MC, Eaton WL, Propert KJ, Ware JH, Zimmer B, Chahinian AP, Skarin A, Carey RW, Kreisman H, Faulkner C et al (1987) Chemotherapy with or without radiation therapy in limited small-cell carcinoma of the lung. N Engl J Med 316:912–918

    Article  PubMed  CAS  Google Scholar 

  • Phase III randomized study of three different thoracic radiotherapy regimens in patients with limited-stage small cell lung cancer receiving cisplatin and etoposide. https://www.ctsu.org/public/data/protocols/CALGB/CALGB-30610/pfs.pdf. Accessed 13 Mar 2011

  • Pignon JP, Arriagada R, Ihde DC, Johnson DH, Perry MC, Souhami RL, Brodin O, Joss RA, Kies MS, Lebeau B et al (1992) A meta-analysis of thoracic radiotherapy for small-cell lung cancer. N Engl J Med 327:1618–1624

    Article  PubMed  CAS  Google Scholar 

  • Pijls-Johannesma M, de Ruysscher D, Vansteenkiste J, Kester A, Rutten I, Lambin P (2007) Timing of chest radiotherapy in patients with limited stage small cell lung cancer: a systematic review and meta-analysis of randomised controlled trials. Cancer Treat Rev 33:461–473

    Article  PubMed  Google Scholar 

  • Rusch VW (2005) Mediastinoscopy: an endangered species? J Clin Oncol 23:8283–8285

    Article  PubMed  Google Scholar 

  • Samson DJ, Seidenfeld J, Simon GR, Turrisi AT 3rd, Bonnell C, Ziegler KM, Aronson N American College of Chest Physicians (2007) Evidence for management of small cell lung cancer: ACCP evidence-based clinical practice guidelines, 2nd edn. Chest 132(3 Suppl):314S–323S

    Google Scholar 

  • Schild SE, Bonner JA, Hillman S et al (2007) Results of a phase II study of high-dose thoracic radiation therapy with concurrent cisplatin and etoposide in limited-stage small-cell lung cancer (NCCTG 95–20-53). J Clin Oncol 25:3124–3129

    Article  PubMed  CAS  Google Scholar 

  • Senan S, de Ruysscher D (2005) Critical review of PET-CT for radiotherapy planning in lung cancer. Crit Rev Oncol Hematol 56:345–351

    Article  PubMed  Google Scholar 

  • Skarlos DV, Samantas E, Briassoulis E, Panoussaki E, Pavlidis N, Kalofonos HP, Kardamakis D, Tsiakopoulos E, Kosmidis P, Tsavdaridis D, Tzitzikas J, Tsekeris P, Kouvatseas G, Zamboglou N, Fountzilas G (2001) Randomized comparison of early versus late hyperfractionated thoracic irradiation concurrently with chemotherapy in limited disease small-cell lung cancer: a randomized phase II study of the Hellenic cooperative oncology group (HeCOG). Ann Oncol 12:1231–1238

    Article  PubMed  CAS  Google Scholar 

  • Slotman B, Faivre-Finn C, Kramer G, Rankin E, Snee M, Hatton M, Postmus P, Collette L, Musat E, Senan S (2007) EORTC radiation oncology group and lung cancer group. Prophylactic cranial irradiation in extensive small-cell lung cancer. N Engl J Med 357:664–672

    Article  PubMed  CAS  Google Scholar 

  • Socinski MA, Bogart JA (2007) Limited-stage small-cell lung cancer: the current status of combined-modality therapy. J Clin Oncol 25:4137–4145

    Article  PubMed  CAS  Google Scholar 

  • Spiro SG, James LE, Rudd RM, Trask CW, Tobias JS, Snee M, Gilligan D, Murray PA, Ruiz de Elvira MC, O’Donnell KM, Gower NH, Harper PG, Hackshaw AK, London Lung Cancer Group (2006) Early compared with late radiotherapy in combined modality treatment for limited disease small-cell lung cancer: a London lung cancer group multicenter randomized clinical trial and meta-analysis. J Clin Oncol 24:3823–3830

    Article  PubMed  CAS  Google Scholar 

  • Tada T, Minakuchi K, Koda M, Masuda N, Matsui K, Kawase I, Nakajima T, Nishioka M, Fukuoka M, Kozuka T (1998) Limited-stage small cell lung cancer: local failure after chemotherapy and radiation therapy. Radiology 208:511–515

    PubMed  CAS  Google Scholar 

  • Takada M, Fukuoka M, Kawahara M, Sugiura T, Yokoyama A, Yokota S, Nishiwaki Y, Watanabe K, Noda K, Tamura T, Fukuda H, Saijo N (2002) Phase III study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan clinical oncology group study 9104. J Clin Oncol 20:3054–3060

    Article  PubMed  CAS  Google Scholar 

  • Turrisi AT 3rd, Kim K, Blum R, Sause WT, Livingston RB, Komaki R, Wagner H, Aisner S, Johnson DH (1999) Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 340:265–2671

    Article  PubMed  CAS  Google Scholar 

  • van Baardwijk A, Baumert BG, Bosmans G, van Kroonenburgh M, Stroobants S, Gregoire V, Lambin P, de Ruysscher D (2006) The current status of FDG-PET in tumour volume definition in radiotherapy treatment planning. Cancer Treat Rev 32:245–260

    Article  PubMed  Google Scholar 

  • van Loon J, de Ruysscher D, Wanders R, Boersma L, Simons J, Oellers M, Dingemans AM, Hochstenbag M, Bootsma G, Geraedts W, Pitz C, Teule J, Rhami A, Thimister W, Snoep G, Dehing-Oberije C, Lambin P (2010) Selective nodal irradiation on basis of (18)FDG-PET scans in limited-disease small-cell lung cancer: a prospective study. Int J Radiat Oncol Biol Phys 77:329–336

    Article  PubMed  Google Scholar 

  • van Overhagen H, Brakel K, Heijenbrok MW, van Kasteren JH, van de Moosdijk CN, Roldaan AC, van Gils AP, Hansen BE (2004) Metastases in supraclavicular lymph nodes in lung cancer: assessment with palpation, US, and CT. Radiology 232:75–80

    Article  PubMed  Google Scholar 

  • Videtic GM, Belderbos JS, Spring Kong FM, Kepka L, Martel MK, Jeremic B (2008) Report from the international atomic energy agency (IAEA) consultants’ meeting on elective nodal irradiation in lung cancer: small-cell lung cancer (SCLC). Int J Radiat Oncol Biol Phys 72:327–334

    Article  PubMed  Google Scholar 

  • Warde P, Payne D (1992) Does thoracic irradiation improve survival and local control in limited-stage small-cell carcinoma of the lung? A meta-analysis. J Clin Oncol 10:890–895

    PubMed  CAS  Google Scholar 

  • Watkins JM, Wahlquist AE, Zauls AJ, Shirai K, Garrett-Mayer E, Aguero EG, Silvestri GA, Sherman CA, Sharma AK (2010) Involved-field radiotherapy with concurrent chemotherapy for limited-stage small-cell lung cancer: disease control, patterns of failure and survival. J Med Imaging Radiat Oncol 54:483–489

    Article  PubMed  Google Scholar 

  • White JE, Chen T, McCracken J, Kennedy P, Seydel HG, Hartman G, Mira J, Khan M, Durrance FY, Skinner O (1982) The influence of radiation therapy quality control on survival, response and sites of relapse in oat cell carcinoma of the lung: preliminary report of a southwest oncology group study. Cancer 50:1084–1090

    Article  PubMed  CAS  Google Scholar 

  • Work E, Nielsen OS, Bentzen SM, Fode K, Palshof T (1997) Randomized study of initial versus late chest irradiation combined with chemotherapy in limited-stage small-cell lung cancer. Aarhus lung cancer group. J Clin Oncol 15:3030–3037

    PubMed  CAS  Google Scholar 

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  1. Department of Radiation Oncology/T28, Taussig Cancer Institute, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Gregory M. M. Videtic

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Correspondence to Gregory M. M. Videtic .

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  1. Institute of Lung Diseases, Institutski put 4, Sremska Kamenica, 21204, Serbia

    Branislav Jeremic

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Videtic, G.M.M. (2011). The Radiation Target in Small-Cell Lung Cancer. In: Jeremic, B. (eds) Advances in Radiation Oncology in Lung Cancer. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2011_251

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  • DOI: https://doi.org/10.1007/174_2011_251

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