I’m presenting a study looking at the role of thoracic radiotherapy in patients who have extensive stage small cell lung cancer. It was a randomised controlled trial comparing radiotherapy to the chest, 30Gy in ten fractions, versus no further radiotherapy given in combination with prophylactic cranial irradiation. In this study 483 patients with so-called extensive stage small cell lung cancer, so the majority had metastatic small cell lung cancer, were randomised between radiotherapy, preventative radiotherapy, given to the brain, the so-called prophylactic cranial irradiation, plus thoracic radiotherapy versus prophylactic cranial irradiation only. The study showed that there was an improvement in survival at two years with an increase of 10%, so 3% two year survival in the group of patients not receiving thoracic radiotherapy compared to 13% in patients receiving the thoracic radiotherapy.

What were your conclusions?

In this study the treatment was well tolerated, there was an improvement in survival at two years, so the conclusion is that this treatment should be offered to patients who have extensive stage small cell lung cancer in addition to prophylactic cranial irradiation. It will be a study that will impact on the standard of care, absolutely.

The side effects were minimal so the risks of developing significant side effects of grade 3 or 4 were very limited. Less than 10% of the patients receiving thoracic radiotherapy developed such side effects. 95% of the patients completed the treatment as per protocol so this treatment is certainly extremely well tolerated, including in patients above the age of 70, and improves survival.