Hypofractionated Radiotherapy Combined with Chemotherapy Shows Promise for Small Cell Lung Cancer Treatment
A new phase III trial shows that a three-week hypofractionated radiotherapy schedule combined with chemotherapy offers similar survival rates and fewer side effects compared to traditional treatment for LS-SCLC patients.
A large-scale, randomized phase III study has demonstrated that a condensed three-week hypofractionated radiotherapy (HypoRT) regimen, administered alongside chemotherapy, yields survival outcomes comparable to the traditional six-week conventional radiotherapy (ConvRT) schedule in patients with limited-stage small cell lung cancer (LS-SCLC). Conducted across 16 hospitals in China and presented at the 2025 World Conference on Lung Cancer by the International Association for the Study of Lung Cancer, this research examined 530 patients allocated to either HypoRT (45 Gy delivered in 15 daily fractions over 3 weeks) or ConvRT (60 Gy over 30 fractions across 6 weeks), both combined with concurrent cisplatin/carboplatin-etoposide chemotherapy.
With a median follow-up of approximately 43.4 months, the study found median overall survival rates of 40.2 months for the HypoRT group and 47.9 months for the ConvRT group, showing no significant difference (HR=1.04; 95% CI, 0.81–1.33). Progression-free survival was also similar between the two schedules.
Importantly, patients undergoing the hypofractionated schedule experienced fewer severe side effects, including notable reductions in hematologic toxicity, lymphopenia, and radiation pneumonitis. Acute grade ≥3 adverse events occurred in 48.7% of HypoRT patients versus 67.7% of those in the conventional group, indicating a safer profile.
Expert opinion from Dr. Nan Bi of the Chinese Academy of Medical Sciences emphasized that hypofractionated radiotherapy offers a shorter, more manageable treatment course with fewer side effects, without compromising survival. This approach is particularly advantageous in settings where reducing treatment duration and toxicity is a priority, potentially improving patient quality of life and healthcare efficiency.
Further investigations are suggested to explore the combination of HypoRT with immunotherapy, which could harness immune-sparing benefits and improve therapeutic outcomes for lung cancer patients.
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