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Bending the Curve Trial by Trial
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Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide

Needs review

N = 417

Population
Patients with limited small-cell lung cancer (disease confined to one hemithorax)
Design
Randomised comparison of 45 Gy of concurrent thoracic radiotherapy given twice daily over three weeks or once daily over five weeks, with four 21-day cycles of cisplatin plus etoposide in all patients; radiotherapy began with the first chemotherapy cycle. The abstract does not state arm sizes, a trial name or number, a phase, or the primary endpoint. Which arm is experimental and which is control is not stated in the abstract: twice-daily is entered as experimental only because the abstract presents it as the intervention of interest.
Arms
  • Twice-daily thoracic radiotherapy (experimental): 45 Gy thoracic radiotherapy twice daily over 3 weeks, concurrent with cisplatin-etoposide
  • Once-daily thoracic radiotherapy (control): 45 Gy thoracic radiotherapy once daily over 5 weeks, concurrent with cisplatin-etoposide
People
Turrisi AT 3rd, senior author Johnson DH
Δ median OS+4 monthsΔ 24-month OS+6 points
Show the numbers
Results reported for Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide
EndpointAnalysisTwice-daily thoracic radiotherapyOnce-daily thoracic radiotherapyEffect
OSRandomised patients (417)primaryTurrisi 1999median 23 months; 47% at 2 y; 26% at 5 ymedian 19 months; 41% at 2 y; 16% at 5 yP=0.04The abstract gives no confidence intervals or hazard ratio. Median follow-up almost 8 years. Grade 3 esophagitis 27% with twice-daily and 11% with once-daily radiotherapy (P<0.001). Landmark figures are survival rates at 2 and 5 years.
Results reported for Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide
EndpointAnalysisTwice-daily thoracic radiotherapyOnce-daily thoracic radiotherapyEffect
OSRandomised patients (417)primaryTurrisi 1999median 23 months; 47% at 2 y; 26% at 5 ymedian 19 months; 41% at 2 y; 16% at 5 yP=0.04The abstract gives no confidence intervals or hazard ratio. Median follow-up almost 8 years. Grade 3 esophagitis 27% with twice-daily and 11% with once-daily radiotherapy (P<0.001). Landmark figures are survival rates at 2 and 5 years.
Illustrative — modelled from reported values, not trial data. OS, primary.
0%25%50%75%100%0102030405060Months (modelled)
  • Twice-daily thoracic radiotherapy (experimental)
  • Once-daily thoracic radiotherapy (control)
Data table (modelled values)
MonthsTwice-daily thoracic radiotherapyOnce-daily thoracic radiotherapy
0100.0%100.0%
1661.8%57.5%
3238.4%31.2%
4930.5%21.6%
6526.0%16.0%
Primary publication: Turrisi AT 3rd, Kim K, Blum R, Sause WT, Livingston RB, Komaki R, et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med. 1999;340(4):265-71. PubMedDOI

Appears in

Sources

  1. Turrisi AT 3rd, Kim K, Blum R, Sause WT, Livingston RB, Komaki R, et al. Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med. 1999;340(4):265-71.

    PubMedDOI