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    A National Survey on the Current Status of Radiotherapy in Extensive Stage Small-cell Lung Cancer: Turkish Society of Radiation Oncology Thoracic Oncology Group Study
    (Kare Publ, 2023) Kirakli, Esra Korkmaz; Erdem, Sevilay; Yalman, Deniz; Saynak, Mert
    OBJECTIVE We aimed to investigate the current status and use of thoracic radiotherapy (TRT) and prophylactic cranial irradiation (PCI) in extensive-stage small-cell lung cancer (ES-SCLC) patients who responded to chemotherapy (ChT) through a nationwide survey. METHODS An electronic survey was created. We invited all the Turkish Society of Radiation Oncology-registered radiation oncologists (ROs). RESULTS A total of 101 ROs participated. TRT was routinely recommended to patients who responded to ChT by 76% of ROs. The highest agreement for TRT indication (%94) was in the case of symptomatic residual disease. The most commonly used fractionation scheme was 30 Gy in 10 fractions. There was an increase in the use of 30 Gy in 10 fractions after the publication of the CREST trial. The implementation criteria for TRT were site and number of metastases for 65% and 42% of respondents, respectively. PCI was recommended by 89% routinely. The most commonly (93%) used fractionation scheme was 25 Gy in 10 fractions. CONCLUSION This survey highlights the absence of consensus on the eligibility criteria and dosage of TRT in ES-SCLC within the Turkish RO community. The highest agreement for the TRT indication was in patients with symptomatic intrathoracic residual disease. The CREST trial impacted TRT indications and fractionation. There was high consistency in practice in terms of PCI indication, dose, and fractionation.
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    Role of Consolidative Thoracic Radiotherapy for Extensive-stage Small Cell Lung Cancer: Trod Thoracic Oncology Study Group 08-006 Multi-institutional Study
    (Kare Publ, 2022) Yavas, Guler; Kirakli, Esra Korkmaz; Dagdelen, Meltem; Topkan, Erkan; Saynak, Mert; Dincbas, Fazilet Oner; OzdemIr, Yurday
    OBJECTIVE We aimed to evaluate the role of consolidative thoracic radiotherapy (TRT) in patients with extensive-stage small cell lung cancer (ES-SCLC). METHODS The clinical data for 151 patients with the diagnosis of ES-SCLC treated with consolidative TRT from six different hospitals from Turkey analyzed. RESULTS The median age of the patients was 61 years (range 36-83 years). The median dose of radiotherapy (RT) was 45 Gy (range: 30-66 Gy) applied in median 25 fractions (range 10-34 fractions). For 151 assessable patients, the median survival time (MST) was 14 months (range: 12.6-15.3). The patients who has complete response and partial response had 16 months, and 14 months of MST. In multivariate analyses prophylactic cranial irradiation (PCI) (p=0.011), female gender (p=0.017), and comorbidity (p=0.006) were found as significant parameters associated with survival. The MSTs were 12 months in patients without comorbidity, and 16 months for the patients with at least one comorbid disease. The patients who received PCI had improved MSTs when compared the ones without PCI (16 months vs. 12 months). There was a trend towards improved overall survival times in patients who received EQD2 >= 47 Gy RT doses (p=0.08). CONCLUSION Female gender, use of PCI, and unavailability of comorbid disease were associated with improved survival in ES-SLCL patients. There was a trend towards overall survival times in patients who received >= 47 Gy EQD2 doses; however, we believe that this statistical insignificance was related to our limited patient numbers.