On repeat.

What do you do for treated small cell lung cancer (SCLC) that returns in the chest? Unfortunately there’s no prospective data on the horizon, but in the meantime we have a small (but international!) retrospective look at outcomes after re-irradiation. Of 33 patients re-treated at a median of 24 months after initial chest radiation, those with extra-thoracic mets (n=7) did horribly—think survival counted in weeks, not months. Otherwise, outcomes were respectable, especially when re-treatment radiation went to a 2 Gy dose-equivalent >40 Gy (n=9), after which over half of patients were still alive at 2 years. TBL: Isolated thoracic SCLC recurrence may merit re-irradiation with an EQD2 >40 Gy, while the presence of other mets should give caution to treating outside a brief palliative course to relieve related symptoms. | Käsmann, Transl Lung Cancer Res 2020