51O - Early limited-stage small cell lung cancer: Sub-group analysis of the concurrent once-daily versus twice-daily radiotherapy (CONVERT) trial

Date 07 May 2017
Event ELCC 2017
Session SCLC and early stage NSCLC
Topics Small-Cell Lung Cancer
Thoracic malignancies
Surgical oncology
Radiation oncology
Presenter Ahmed Salem
Citation Annals of Oncology (2017) 28 (suppl_2): ii17-ii20. 10.1093/annonc/mdx088
Authors A. Salem1, L. Ashcroft2, A. Dagnault3, C. de Metz4, M. Hatton5, I. Locke6, I. Monnet7, L. Padovani8, F. Blackhall9, C. Faivre-Finn9
  • 1Division Of Molecular And Clinical Cancer Sciences, University of Manchester, M20 3LJ - Manchester/GB
  • 2The Christie NHS Foundation Trust, Manchester/GB
  • 3Centre Hospitalier Universitaire Pavillon l'Hôtel-Dieu de Quebec, Quebec City/CA
  • 4Cancer Centre of Southeastern Ontario, Kingston/CA
  • 5Weston Park Hospital Cancer Research Centre, Sheffield/GB
  • 6Royal Marsden Hospital NHS Foundation Trust, London/GB
  • 7CHI de Créteil, Paris/FR
  • 8CHU de Marseille, Marseille/FR
  • 9Division Of Molecular And Clinical Cancer Sciences, University of Manchester, Manchester/GB



There is little evidence to guide the management of early limited-stage small cell lung cancer (LS-SCLC). We examined outcome of early LS-SCLC patients treated within a contemporary trial.


This is an exploratory analysis of early (TNM stage I-II) LS-SCLC patients included in the CONVERT trial. This is a randomized phase III trial that compared twice-daily (45 Gray (Gy) in 30 twice-daily fractions over 3 weeks) and once-daily (66 Gy in 33 daily fractions over 6.5 weeks) radiotherapy starting on day 22 of chemotherapy cycle 1 in good performance score (PS) patients. Chemotherapy consisted of 4-6 cycles of cisplatin and etoposide. Prophylactic cranial irradiation (PCI) was offered if indicated. Radiotherapy was delivered using three-dimensional conformal or intensity modulated technique.


Between 2008 and 2013, 547 patients were recruited to this trial. Five hundred and thirteen patients were eligible for this analysis and 87 (17%) had early disease. Staging flurodeoxyglucose positron emission tomography (FDG-PET) use (68% versus 55.4%, p = 0.05) and baseline PS (PS0 57.5% versus 43.2%, p = 0.04) were different between early and non-early LS-SCLC patients, respectively. Early patients achieved longer overall survival (median 50 versus 25 months, p = 0.001) and time to local (median 40 versus 17 months, p = 0.0017) and metastatic progression (median 49 versus 16 months, p = 0.0004) compared to non-early patients, irrespective of treatment arm. In early patients, there was no significant overall survival difference between treatment arms, p = 0.31. Radiotherapy compliance was significantly higher in early patients (p = 0.004) and these patients were less likely to experience grade ≥3 acute oesophagitis, compared to non-early patients (11% versus 21%, p < 0.005).


Early LS-SCLC patients achieve good long-term survival with minimal acute side-effects following chemo-radiotherapy and PCI. This study guides practice and provides a benchmark for future studies comparing a surgical to a non-surgical approach in this patient cohort.

Clinical trial identification

ISRCTN91927162, NCT00433563

Legal entity responsible for the study

MAHSC-CTU, The Christie NHS Foundation Trust, Manchester, UK


Cancer Research UK


All authors have declared no conflicts of interest.