Prospective Evaluation of Limited Stage Small Cell Lung Cancer (LS-SCLC) Fractionation Regimen Usage and Toxicity in a Large Statewide Quality Collaborative
dc.contributor.author | Allen, Steven G | |
dc.contributor.author | Dragovic, Aleksandar F | |
dc.contributor.author | Yin, Maggie | |
dc.contributor.author | Bryant, Alex K | |
dc.contributor.author | Paximadis, Peter | |
dc.contributor.author | Matuszak, Martha | |
dc.contributor.author | Schipper, Matthew | |
dc.contributor.author | Dess, Robert | |
dc.contributor.author | Hayman, James | |
dc.contributor.author | Pierce, Lori | |
dc.contributor.author | Dominello, Michael | |
dc.contributor.author | Kestin, Larry | |
dc.contributor.author | Grills, Inga | |
dc.contributor.author | Movsas, Benjamin | |
dc.contributor.author | Jolly, Shruti | |
dc.contributor.author | Bergsma, Derek | |
dc.contributor.author | Consortium, on behalf of the Michigan Radiation Oncology Quality | |
dc.coverage.spatial | Scottsdale, AZ | |
dc.date.accessioned | 2023-05-31T19:02:41Z | |
dc.date.available | 2023-05-31T19:02:41Z | |
dc.date.issued | 2023-04-24 | |
dc.identifier.issn | 1879-8500 | |
dc.identifier.issn | 1879-8519 | |
dc.identifier.uri | https://www.ncbi.nlm.nih.gov/pubmed/37100388 | |
dc.identifier.uri | https://hdl.handle.net/2027.42/176789 | en |
dc.description.abstract | PURPOSE: National guidelines on limited stage small cell lung cancer (LS-SCLC) treatment give preference to a hyperfractionated regimen of 45 Gy/30 fractions delivered twice-daily, however use of this regimen is uncommon compared to once-daily regimens. The purpose of this study was to characterize the LS-SCLC fractionation regimens used throughout a statewide collaborative, analyze patient and treatment factors associated with these regimens, and describe real-world acute toxicity profiles of once- and twice-daily RT regimens. METHODS AND MATERIALS: Demographic, clinical, and treatment data along with physician toxicity and patient-reported outcomes were prospectively collected by 29 institutions within the [quality consortium] between 2012 and 2021 for patients with LS-SCLC. We modeled the influence of RT fractionation and other patient-level variables clustered by treatment site on the odds of a treatment break specifically due to toxicity with multilevel logistic regression. Common Terminology Criteria for Adverse Events, version 4.0, incident Grade 2 or worse toxicity was longitudinally compared between regimens. RESULTS: There were 78 patients (15.6% overall) treated with twice-daily RT and 421 patients treated with once-daily RT. Patients receiving twice-daily RT were more likely to be married/living with someone (65% vs 51%, p=0.019) and to have no major comorbidities (24% vs 10%, p=0.017). Once-daily RT fractionation toxicity peaked during RT and twice-daily toxicity peaked within 1 month after RT. After stratifying by treatment site and adjusting for patient-level variables, once-daily treated patients had a 4.11 (95% confidence interval 1.31-12.87) higher odds of treatment break specifically due to toxicity than twice-daily treated patients. CONCLUSION: Hyperfractionation for LS-SCLC remains infrequently prescribed despite the lack of evidence demonstrating superior efficacy or lower toxicity of once-daily RT. With peak acute toxicity after RT and lower likelihood of a treatment break with twice-daily fractionation in real-word practice, providers may start utilizing hyperfractionated RT more frequently. | |
dc.format.medium | Print-Electronic | |
dc.publisher | Elsevier | |
dc.subject | Michigan Radiation Oncology Quality Consortium | |
dc.title | Prospective Evaluation of Limited Stage Small Cell Lung Cancer (LS-SCLC) Fractionation Regimen Usage and Toxicity in a Large Statewide Quality Collaborative | |
dc.type | Conference Paper | |
dc.identifier.pmid | 37100388 | |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/176789/2/1-s2.0-S1879850023001145-main.pdf | |
dc.identifier.doi | 10.1016/j.prro.2023.04.007 | |
dc.identifier.doi | https://dx.doi.org/10.7302/7638 | |
dc.identifier.source | Pract Radiat Oncol | |
dc.description.version | Published online | |
dc.date.updated | 2023-05-31T19:02:37Z | |
dc.identifier.orcid | 0000-0002-4129-1030 | |
dc.identifier.orcid | 0000-0001-6728-4720 | |
dc.identifier.orcid | 0000-0003-2331-3758 | |
dc.identifier.orcid | 0000-0003-1391-5608 | |
dc.identifier.orcid | 0000-0002-8174-5199 | |
dc.identifier.orcid | 0000-0002-6293-4496 | |
dc.description.filedescription | Description of 1-s2.0-S1879850023001145-main.pdf : Published version | |
dc.identifier.startpage | S1879-8500(23)00114-5 | |
dc.identifier.name-orcid | Allen, Steven G | |
dc.identifier.name-orcid | Dragovic, Aleksandar F | |
dc.identifier.name-orcid | Yin, Maggie | |
dc.identifier.name-orcid | Bryant, Alex K | |
dc.identifier.name-orcid | Paximadis, Peter | |
dc.identifier.name-orcid | Matuszak, Martha; 0000-0002-4129-1030 | |
dc.identifier.name-orcid | Schipper, Matthew; 0000-0001-6728-4720 | |
dc.identifier.name-orcid | Dess, Robert; 0000-0003-2331-3758 | |
dc.identifier.name-orcid | Hayman, James; 0000-0003-1391-5608 | |
dc.identifier.name-orcid | Pierce, Lori | |
dc.identifier.name-orcid | Dominello, Michael | |
dc.identifier.name-orcid | Kestin, Larry | |
dc.identifier.name-orcid | Grills, Inga | |
dc.identifier.name-orcid | Movsas, Benjamin | |
dc.identifier.name-orcid | Jolly, Shruti; 0000-0002-8174-5199 | |
dc.identifier.name-orcid | Bergsma, Derek; 0000-0002-6293-4496 | |
dc.identifier.name-orcid | Consortium, on behalf of the Michigan Radiation Oncology Quality | |
dc.working.doi | 10.7302/7638 | en |
dc.owningcollname | Radiation Oncology, Department of |
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