Sager O, Dincoglan F, Demiral S, Gamsiz H, Uysal B, Ozcan F, Colak O, Gumustepe E, Elcim Y, Gundem E, Dirican B, Beyzadeoglu M. Optimal timing of thoracic irradiation for limited stage small cell lung cancer: Current evidence and future prospects. World J Clin Oncol 2022; 13(2): 116-124 [PMID: 35316927 DOI: 10.5306/wjco.v13.i2.116]
Corresponding Author of This Article
Omer Sager, MD, Associate Professor, Gulhane Medical Faculty Department of Radiation Oncology, University of Health Sciences, Gn Dr Tevfik Saglam Street, Ankara 0090, Turkey. omersager@gmail.com
Research Domain of This Article
Oncology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. Feb 24, 2022; 13(2): 116-124 Published online Feb 24, 2022. doi: 10.5306/wjco.v13.i2.116
Optimal timing of thoracic irradiation for limited stage small cell lung cancer: Current evidence and future prospects
Omer Sager, Ferrat Dincoglan, Selcuk Demiral, Hakan Gamsiz, Bora Uysal, Fatih Ozcan, Onurhan Colak, Esra Gumustepe, Yelda Elcim, Esin Gundem, Bahar Dirican, Murat Beyzadeoglu
Omer Sager, Ferrat Dincoglan, Selcuk Demiral, Hakan Gamsiz, Bora Uysal, Fatih Ozcan, Onurhan Colak, Esra Gumustepe, Yelda Elcim, Esin Gundem, Bahar Dirican, Murat Beyzadeoglu, Gulhane Medical Faculty Department of Radiation Oncology, University of Health Sciences, Ankara 0090, Turkey
Author contributions: Sager O, Dincoglan F, Demiral S, Gamsiz H, Uysal B, Ozcan F Colak O and Gumustepe E played significant role in data acquisition, interpretation of data, reviewing and writing of the manuscript; Elcim Y, Gundem E and Dirican B worked on checking the manuscript for important intellectual content; Beyzadeoglu M took part in designing, reviewing and writing of the manuscript and checking the manuscript for important intellectual content; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors state that they have no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Omer Sager, MD, Associate Professor, Gulhane Medical Faculty Department of Radiation Oncology, University of Health Sciences, Gn Dr Tevfik Saglam Street, Ankara 0090, Turkey. omersager@gmail.com
Received: April 8, 2021 Peer-review started: April 8, 2021 First decision: June 16, 2021 Revised: June 21, 2021 Accepted: January 11, 2022 Article in press: January 11, 2022 Published online: February 24, 2022 Processing time: 321 Days and 4.3 Hours
Abstract
Lung cancer is a global health concern as the leading cause of cancer related mortality worldwide. Small cell lung cancer (SCLC) poses a formidable challenge to the treating physicians with the worst prognosis among all lung cancers. However, limited stage SCLC (LS-SCLC) has a relatively better outcome with multimodality management. Efforts have been focused on optimal integration of treatment modalities to achieve an improved therapeutic ratio for patients with LS-SCLC. While chemotherapy and thoracic radiation therapy (TRT) are primary components of initial management for LS-SCLC, there is no consensus on optimal timing of TRT. Within this context, we herein provide a concise overview of current evidence and future prospects regarding the optimal timing of thoracic irradiation for LS-SCLC in light of the literature.
Core Tip: There has been extensive effort to establish optimal timing of thoracic radiation therapy (TRT) in limited stage small cell lung cancer (LS-SCLC) management. While late TRT may have utility for management of LS-SCLC patients who may not tolerate curative-intent upfront chest irradiation due to excessive tumor burden at the outset, early TRT allows for exploiting the synergistic effect of chemoradiotherapy to eradicate as many tumor cells as possible in a shorter timeframe. Admittedly, differences in trial designs, definition of early and late TRT, patient selection criteria, administered chemotherapy regimens, treatment compliance, TRT dose and fractionation may affect treatment outcomes.
