KEY TAKEAWAYS
- The CONVERT trial aimed to analyze long term efficacy outcome by comparing OD and BD RT in SCLC patients.
- The results showed that after extended follow-up, given similar efficacy and less toxicity, 45 Gy BD continued to be the SOC for SCLC.
Gerard Walls aimed to present the updated analysis of CONVERT, a phase III international randomized clinical trial, detailing the 6.5-year outcomes of once-daily (OD) and twice-daily (BD) radiation therapy (RT) in small cell lung cancer (SCLC) patients.
Patients were randomized equally to receive either OD RT (66 Gy/33 fractions/6.5 weeks) or BD RT (45 Gy/30 fractions/3 weeks). Both regimens were administered concurrently with cisplatin/etoposide. Mandatory three-dimensional conformal RT was used, with optional intensity-modulated RT permitted. Elective nodal irradiation was prohibited. Prophylactic cranial irradiation was administered based on clinician discretion, and RT treatment planning underwent central quality assurance.
About 547 patients across 73 centers were recruited, with a median follow-up of 81.2 months for the surviving cohort (n=164). Median survival for the OD and BD arms was 25.4 months (95%CI 21.1–30.9) and 30.0 months (95%CI 25.3–36.5) respectively, with a HR of 1.13 (95%CI 0.92–1.38), P=0.247. Performance status and tumor volume correlated with survival on multivariate analysis.
No treatment-related deaths occurred after the initial analysis in 2017. Late toxicity included grade 3 esophagitis in 7 OD patients, 4 of whom developed stricture or fistulation, compared to none in the BD arm. Grade 3 pulmonary fibrosis occurred in 2 OD and 3 BD patients.
The study concluded that since the CONVERT trial did not establish the superiority of OD RT and showed a slightly worse toxicity profile after 80 months of follow-up, 45 Gy BD should continue to be the standard of care (SOC) in limited stage SCLC.
The trial was sponsored by The Christie NHS Foundation Trust.
Source:https://cslide.ctimeetingtech.com/elcc24hybrid/attendee/confcal/show/session/7
Clinical Trial: https://clinicaltrials.gov/study/NCT00433563
Walls G. (2024) “Long-term outcomes after concurrent once- or twice-daily chemoradiation in limited-stage small cell lung cancer: A brief report from the CONVERT trial.” Presented at ELCC 2024 (1930).
