Corinne Faivre-Finn, Professor of thoracic radiation oncology and honorary consultant clinical oncologist
|Professor Corinne Faivre-Finn|
The aim of CONVERT was to establish a standard combination of chemotherapy and radiotherapy in small cell lung cancer that hasn’t spread. Before this study it was unclear whether having radiotherapy once or twice a day helped more patients survive for longer and what level of side effects was expected with modern radiotherapy techniques.
Around 550 patients from around the world were split into two groups, one group received radiotherapy twice a day over three weeks (standard treatment) and the other once a day at a higher dose over six and a half weeks (experimental treatment). All patients also had chemotherapy.
Colleagues from The University of Manchester, The Christie, around the UK, France, Spain, Belgium, Netherlands, Poland, Slovenia and Canada compared survival and side effects for both groups. The first patient was enrolled in the study in April 2008 and the last patient in November 2013.
We found that small cell lung cancer patients live longer and with fewer side effects than previous studies.
The length of survival in both groups was similar with 56 per cent of patients who had radiotherapy twice a day surviving for two years compared with 51 per cent of those given it once a day. Importantly, the majority of side effects from radiotherapy were similar in both groups.
Compared to previous studies, we found that half the number of patients than expected experienced complications that required a stay in hospital. This reduction in side-effects is likely to be due to the use of modern radiotherapy techniques.
We are very pleased that our results are providing robust evidence on the best way to treat small cell lung cancer that hasn’t spread outside the chest. Based on our findings, twice–daily radiotherapy with chemotherapy should continue to be considered the standard of care, as once-daily radiotherapy did not prove that survival improved compared to the standard twice-daily treatment. However, given the similar results in both groups it is reasonable to offer once daily radiotherapy if twice daily treatment cannot be delivered due to either patients or the hospital’s preference. Patients can now plan their treatment with their doctors according to what works best for them and their hospital.
Although the trial will still be following up patients for five years, the results are already changing clinical practice within the UK and internationally. We have received many testimonies from patients who are very grateful to be alive several years after receiving treatment.
There have been too many people involved in CONVERT to thank them all individually, but this trial was a fantastic international collaboration that could not have achieved its results without the dedication, commitment and support of countless colleagues. The study was funded by Cancer Research UK and was developed with, set-up and co-ordinated by the Manchester Academic Health Science Centre Clinical Trials Unit which is based here at The Christie.
More information about the CONVERT trial is available here.
For further information about Professor Corinne Faivre-Finn visit her consultant profile.