Multicenter phase 3 trial of high-dose once-daily thoracic radiotherapy for limited-stage small cell lung cancer

Although level 1 evidence supports 45-Gy twice-daily radiotherapy as standard for limited-stage small-cell lung cancer (LS-SCLC), most patients in clinical practice receive higher-dose once-daily regimens. The multicenter phase 3 CALGB 30160/RTOG 0538 trial compared 70-Gy once-daily versus 45-Gy twice-daily for LS-SCLC. Median survival was 28.5 months for the twice-daily treatment versus 30.1 months for the once-daily treatment, with 5-year OS or 29% and 32%, respectively. Treatment was tolerable, and the frequency of severe adverse events was similar for both arms. The authors conclude that the study provides the most robust information available to help guide the choice of thoracic radiotherapy regimen for LS-SCLC patients.