SynthesisAnnals of oncology : official journal of the European Society for Medical Oncology2016
Impact of thoracic radiotherapy timing in limited-stage small-cell lung cancer: usefulness of the individual patient data meta-analysis.
Synthesis in Annals of oncology : official journal of the European Society for Medical Oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Small-cell lung cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upAnnals of oncology : official journal of the European Society for Medical Oncology · 2021Guideline
- Radiation Therapy for Small Cell Lung Cancer: An ASTRO Clinical Practice Guideline.Practical radiation oncologyGuideline
- Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial.The Lancet. Oncology · 2017Trial
- Imaging-guided adaptive radiation therapy in limited-stage small cell lung cancer: Current evidence and clinical perspectives.World journal of radiology · 2026Review
- Chemotherapy and Radiotherapy Regimens for Limited-Stage Small Cell Lung Cancer Treated With Accelerated Hyperfractionated Radiotherapy Combined With Chemotherapy: A Real-World Study.Cancer medicine · 2026Article
- Durvalumab Consolidation Treatment Following Concurrent Chemoradiotherapy in Limited-Stage SCLC: ADRIATIC China Subgroup Analysis.JTO clinical and research reports · 2026Article
- Clinical impact and prognostic factors of early radiotherapy in limited-disease small-cell lung cancer cohort.Journal of thoracic disease · 2026Article
- Timing, fractionation, and dose of thoracic radiotherapy in patients with extensive-stage small cell lung cancer undergoing first-line Chemo-Immunotherapy.Clinical and translational radiation oncology · 2026Article
- Elective nodal irradiation of high-risk regions is superior to involved field radiotherapy for limited-stage small cell lung cancer: a propensity score-matched retrospective study.Radiation oncology (London, England) · 2026Article
- The Five-Decade Journey of Small Cell Lung Cancer.Cancer communications (London, England) · 2026Review
- Advances in Immunotherapy and Chemoradiotherapy Combination for Limited-Stage Small-Cell Lung Cancer: Current Landscape and Future Frontiers.Current oncology reports · 2025Review
- Real-World Analysis of Treatment Patterns in Limited-Stage Small Cell Lung Cancer: Implications for Clinical Practice.Thoracic cancer · 2025Article
- Molecular mechanism of radiation tolerance in lung adenocarcinoma cells using single-cell RNA sequencing.Journal of cellular and molecular medicine · 2024Article
- Thoracic radiotherapy timing and prognostic factors in elderly patients with limited-stage small cell lung cancer.Precision radiation oncology · 2024Article
- SEOM-GECP Clinical guidelines for diagnosis, treatment and follow-up of small-cell lung cancer (SCLC) (2022).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023Article
- Progress in radiotherapy for small-cell lung cancer.Precision radiation oncology · 2023Review
- Survey of treatment and care practices in small-cell lung cancer among German radiation oncologists.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2023Article
- Coronavirus disease 2019 and lung cancer: where are we?Exploration of targeted anti-tumor therapy · 2023Review
- Review
- Prognostic ability of lung immune prognostic index in limited-stage small cell lung cancer.BMC cancer · 2022Article
Corrections and comments
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Authors and funding
19 authors.
Funding
Abstract
backgroundChemotherapy (CT) combined with radiotherapy is the standard treatment of 'limited-stage' small-cell lung cancer. However, controversy persists over the optimal timing of thoracic radiotherapy and CT. MATERIALS AND
methodsWe carried out a meta-analysis of individual patient data in randomized trials comparing earlier versus later radiotherapy, or shorter versus longer radiotherapy duration, as defined in each trial. We combined the results from trials using the stratified log-rank test to calculate pooled hazard ratios (HRs). The primary outcome was overall survival.
resultsTwelve trials with 2668 patients were eligible. Data from nine trials comprising 2305 patients were available for analysis. The median follow-up was 10 years. When all trials were analysed together, 'earlier or shorter' versus 'later or longer' thoracic radiotherapy did not affect overall survival. However, the HR for overall survival was significantly in favour of 'earlier or shorter' radiotherapy among trials with a similar proportion of patients who were compliant with CT (defined as having received 100% or more of the planned CT cycles) in both arms (HR 0.79, 95% CI 0.69-0.91), and in favour of 'later or longer' radiotherapy among trials with different rates of CT compliance (HR 1.19, 1.05-1.34, interaction test, P < 0.0001). The absolute gain between 'earlier or shorter' versus 'later or longer' thoracic radiotherapy in 5-year overall survival for similar and for different CT compliance trials was 7.7% (95% CI 2.6-12.8%) and -2.2% (-5.8% to 1.4%), respectively. However, 'earlier or shorter' thoracic radiotherapy was associated with a higher incidence of severe acute oesophagitis than 'later or longer' radiotherapy.
conclusion'Earlier or shorter' delivery of thoracic radiotherapy with planned CT significantly improves 5-year overall survival at the expense of more acute toxicity, especially oesophagitis.
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