{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,11]],"date-time":"2026-01-11T05:18:55Z","timestamp":1768108735045,"version":"3.49.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Martin-Luther-Universit\u00e4t Halle-Wittenberg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Strahlenther Onkol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The management of small-cell lung cancer shows differences, particularly with regard to the use of radio- (RT), chemo-, and immunotherapy. We performed a\u00a0survey among German radiation oncologists to assess the management of small-cell lung cancer (SCLC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A\u00a034-question online survey was created and sent out by e\u2011mail to radiation oncologists throughout Germany. The survey period extended from August 2020 to January 2021. The questions addressed indications for RT, planning techniques, dosing\/fractionation, target volume definition for consolidative thoracic irradiation, and the use of prophylactic cranial irradiation (PCI). At the same time, we surveyed the use of atezolizumab. The survey addressed the treatment practice for limited-stage SCLC (LS-SCLC) and extensive-stage SCLC (ES-SCLC).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We received 74\u00a0responses. In LS-SCLC, treatment is planned predominantly based on diagnostic information from computed tomography (CT) of the thorax\/abdomen\/pelvis (88%), PET-CT (86%), and pulmonary function testing (88%). In LS-SCLC, 99% of respondents perform radiation concurrently with chemotherapy, preferably starting with cycle one or two (71%) of chemotherapy. The most common dose and fractionation schedule was 60\u201366\u202fGy in 30\u201333 fractions (once daily: 62% of all respondents). In ES-SCLC, 30\u202fGy in 10\u00a0fractions (once daily: 33% of all respondents) was the most commonly used regimen in consolidative thoracic irradiation. Only 25% use chemosensitization with RT. The inclusion criteria for PCI were similar for limited and extensive disease, with Karnofsky index (78% and 75%) being the most important decision factor. Respondents use a\u00a0schedule of 30\u202fGy in 15\u00a0fractions most frequently in both stages (68% limited stage [LS], 60% extensive stage [ES]). Immunotherapy was used regularly or occasionally in LS-SCLC by 45% of respondents, with reduced lung function (37%), cardiac comorbidities (30%), and hepatic insufficiency (30%) being the most commonly mentioned exclusion criteria for this form of therapy. In ES-SCLC, atezolizumab use was reported in 78% of all questionnaires. Half of the respondents (49%) administer it simultaneously with cranial irradiation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Our survey showed variability in the management of SCLC. Results from future studies might help to clarify open questions regarding the optimal treatment paradigms. In addition, new treatment modalities, such as immunotherapy, might change practices in the near future.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-022-02019-9","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T16:24:06Z","timestamp":1669307046000},"page":"631-644","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Survey of treatment and care practices in small-cell lung cancer among German radiation oncologists"],"prefix":"10.1007","volume":"199","author":[{"given":"J.","family":"Gn\u00fcchtel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Vordermark","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Medenwald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"2019_CR1","unstructured":"Zentrum f\u00fcr Krebsregisterdaten \u2013 Krebsarten \u2013 Lungenkrebs (Bronchialkarzinom). https:\/\/www.krebsdaten.de\/Krebs\/DE\/Content\/Krebsarten\/Lungenkrebs\/lungenkrebs_node.html. Accessed: 09.01.2020"},{"issue":"6","key":"2019_CR2","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1016\/1010-7940(91)90040-q","volume":"5","author":"E Ulsperger","year":"1991","unstructured":"Ulsperger\u00a0E, Karrer\u00a0K, Denck\u00a0H (1991) Multimodality treatment for small cell bronchial carcinoma. Preliminary results of a\u00a0prospective, multicenter trial. The ISC-Lung Cancer Study Group. Eur J Cardiothorac Surg 5(6):306\u2013310. https:\/\/doi.org\/10.1016\/1010-7940(91)90040-q","journal-title":"Eur J Cardiothorac Surg"},{"issue":"5","key":"2019_CR3","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1016\/S1470-2045(17)30230-9","volume":"18","author":"T Takahashi","year":"2017","unstructured":"Takahashi\u00a0T, Yamanaka\u00a0T, Seto\u00a0T et al (2017) Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a\u00a0multicentre, randomised, open-label, phase 3 trial. Lancet Oncol 18(5):663\u2013671. https:\/\/doi.org\/10.1016\/S1470-2045(17)30230-9","journal-title":"Lancet Oncol"},{"issue":"3","key":"2019_CR4","doi-asserted-by":"publisher","first-page":"184","DOI":"10.3747\/co.23.3023","volume":"23","author":"J Shahi","year":"2016","unstructured":"Shahi\u00a0J, Wright\u00a0JR, Gabos\u00a0Z, Swaminath\u00a0A (2016) Management of small-cell lung cancer with radiotherapy\u2014a pan-Canadian survey of radiation oncologists. Curr Oncol 23(3):184\u2013195. https:\/\/doi.org\/10.3747\/co.23.3023","journal-title":"Curr Oncol"},{"issue":"23","key":"2019_CR5","doi-asserted-by":"publisher","first-page":"2220","DOI":"10.1056\/NEJMoa1809064","volume":"379","author":"L Horn","year":"2018","unstructured":"Horn\u00a0L, Mansfield\u00a0AS, Szcz\u0119sna\u00a0A et al (2018) First-line atezolizumab plus chemotherapy in extensive-stage small-cell lung cancer. N\u00a0Engl J Med 379(23):2220\u20132229. https:\/\/doi.org\/10.1056\/NEJMoa1809064","journal-title":"N Engl J Med"},{"issue":"10212","key":"2019_CR6","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/S0140-6736(19)32222-6","volume":"394","author":"L Paz-Ares","year":"2019","unstructured":"Paz-Ares\u00a0L, Dvorkin\u00a0M, Chen\u00a0Y et al (2019) Durvalumab plus platinum-etoposide versus platinum-etoposide in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): a\u00a0randomised, controlled, open-label, phase 3 trial. Lancet 394(10212):1929\u20131939. https:\/\/doi.org\/10.1016\/S0140-6736(19)32222-6","journal-title":"Lancet"},{"key":"2019_CR7","unstructured":"(2021) Durvalumab zur Erstlinientherapie des kleinzelligen Lungenkarzinoms im fortgeschrittenen Stadium. https:\/\/www.arzneimitteltherapie.de\/heftarchiv\/2021\/05\/durvalumab-zur-erstlinientherapie-des-kleinzelligen-lungenkarzinoms-im-fortgeschrittenen-stadium.html. Accessed: 01.06.2022"},{"key":"2019_CR8","unstructured":"(2020) Stellungnahme zur Nutzenbewertung gem\u00e4\u00df \u00a7 35a SGB V \u2013 Atezolizumab (kleinzelliges Lungenkarzinom, SCLC). https:\/\/www.dgho.de\/publikationen\/stellungnahmen\/fruehe-nutzenbewertung\/atezolizumab\/atezolizumab-neues-anwendungsgebiet-sclc-dgho-dgp-aio-stellungnahme-20200205.pdf. Accessed: 01.06.2022"},{"key":"2019_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00066-021-01812-2","volume":"197","author":"C Lapa","year":"2021","unstructured":"Lapa\u00a0C, Nestle\u00a0U, Albert\u00a0NL et\u00a0al (2021) Value of PET imaging for radiation therapy. Strahlenther Onkol 197:1\u201323. https:\/\/doi.org\/10.1007\/s00066-021-01812-2","journal-title":"Strahlenther Onkol"},{"issue":"8","key":"2019_CR10","doi-asserted-by":"publisher","first-page":"1116","DOI":"10.1016\/S1470-2045(17)30318-2","volume":"18","author":"C Faivre-Finn","year":"2017","unstructured":"Faivre-Finn\u00a0C, Snee\u00a0M, Ashcroft\u00a0L et al (2017) Concurrent once-daily versus twice-daily chemoradiotherapy in patients with limited-stage small-cell lung cancer (CONVERT): an open-label, phase 3, randomised, superiority trial. Lancet Oncol 18(8):1116\u20131125. https:\/\/doi.org\/10.1016\/S1470-2045(17)30318-2","journal-title":"Lancet Oncol"},{"issue":"3","key":"2019_CR11","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1016\/S1470-2045(20)30742-7","volume":"22","author":"BH Gr\u00f8nberg","year":"2021","unstructured":"Gr\u00f8nberg\u00a0BH, Killingberg\u00a0KT, Fl\u00f8tten \u00d8 et al (2021) High-dose versus standard-dose twice-daily thoracic radiotherapy for patients with limited stage small-cell lung cancer: an open-label, randomised, phase 2 trial. Lancet Oncol 22(3):321\u2013331. https:\/\/doi.org\/10.1016\/S1470-2045(20)30742-7","journal-title":"Lancet Oncol"},{"issue":"2","key":"2019_CR12","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1200\/JCO.1993.11.2.336","volume":"11","author":"N Murray","year":"1993","unstructured":"Murray\u00a0N, Coy\u00a0P, Pater\u00a0JL et al (1993) Importance of timing for thoracic irradiation in the combined modality treatment of limited-stage small-cell lung cancer. The National Cancer Institute of Canada Clinical Trials Group. J\u00a0Clin Oncol 11(2):336\u2013344. https:\/\/doi.org\/10.1200\/JCO.1993.11.2.336","journal-title":"J Clin Oncol"},{"issue":"10","key":"2019_CR13","doi-asserted-by":"publisher","first-page":"1818","DOI":"10.1093\/annonc\/mdw263","volume":"27","author":"D De Ruysscher","year":"2016","unstructured":"De Ruysscher\u00a0D, Lueza\u00a0B, Le P\u00e9choux\u00a0C et al (2016) Impact of thoracic radiotherapy timing in limited-stage small-cell lung cancer: usefulness of the individual patient data meta-analysis. Ann Oncol 27(10):1818\u20131828. https:\/\/doi.org\/10.1093\/annonc\/mdw263","journal-title":"Ann Oncol"},{"key":"2019_CR14","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1007\/s00066-019-01539-1","volume":"196","author":"X Hu","year":"2020","unstructured":"Hu\u00a0X, Xia\u00a0B, Bao\u00a0Y et al (2020) Timing of thoracic radiotherapy is more important than dose intensification in patients with limited-stage small cell lung cancer: a\u00a0parallel comparison of two prospective studies. Strahlenther Onkol 196:172\u2013181. https:\/\/doi.org\/10.1007\/s00066-019-01539-1","journal-title":"Strahlenther Onkol"},{"issue":"1","key":"2019_CR15","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1186\/s12885-018-5251-3","volume":"19","author":"X Yin","year":"2019","unstructured":"Yin\u00a0X, Yan\u00a0D, Qiu\u00a0M, Huang\u00a0L, Yan\u00a0SX (2019) Prophylactic cranial irradiation in small cell lung cancer: a\u00a0systematic review and meta-analysis. BMC Cancer 19(1):95. https:\/\/doi.org\/10.1186\/s12885-018-5251-3","journal-title":"BMC Cancer"},{"issue":"2","key":"2019_CR16","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1016\/j.jtho.2018.09.019","volume":"14","author":"A Levy","year":"2019","unstructured":"Levy\u00a0A, Le P\u00e9choux\u00a0C, Mistry\u00a0H et al (2019) Prophylactic cranial irradiation for limited-stage small-cell lung cancer patients: secondary findings from the prospective randomized phase 3 CONVERT trial. J\u00a0Thorac Oncol 14(2):294\u2013297. https:\/\/doi.org\/10.1016\/j.jtho.2018.09.019","journal-title":"J Thorac Oncol"},{"key":"2019_CR17","doi-asserted-by":"publisher","first-page":"1152","DOI":"10.1007\/s00066-018-1362-7","volume":"194","author":"Y Zheng","year":"2018","unstructured":"Zheng\u00a0Y, Wang\u00a0L, Zhao\u00a0W et\u00a0al (2018) Risk factors for brain metastasis in patients with small cell lung cancer without prophylactic cranial irradiation. Strahlenther Onkol 194:1152\u20131162. https:\/\/doi.org\/10.1007\/s00066-018-1362-7","journal-title":"Strahlenther Onkol"},{"key":"2019_CR18","doi-asserted-by":"publisher","unstructured":"Higgins\u00a0K, Hu\u00a0C, Ross\u00a0H et al (2019) NRG oncology\/alliance LU005: a\u00a0phase II\/III randomized study of chemoradiation versus chemoradiation plus atezolizumab in LS-SCLC. J\u00a0Thorac Oncol. https:\/\/doi.org\/10.1200\/JCO.2020.38.15. suppl.TPS9082 J\u00a0Clin Oncol 38(15_suppl)","DOI":"10.1200\/JCO.2020.38.15"},{"issue":"7","key":"2019_CR19","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1056\/NEJMoa071780","volume":"357","author":"B Slotman","year":"2007","unstructured":"Slotman\u00a0B, Faivre-Finn\u00a0C, Kramer\u00a0G et al (2007) Prophylactic cranial irradiation in extensive small-cell lung cancer. N\u00a0Engl J Med 357(7):664\u2013672. https:\/\/doi.org\/10.1056\/NEJMoa071780","journal-title":"N Engl J Med"},{"issue":"6","key":"2019_CR20","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1016\/j.jtho.2018.02.024","volume":"13","author":"CH Maeng","year":"2018","unstructured":"Maeng\u00a0CH, Song\u00a0JU, Shim\u00a0SR, Lee\u00a0J (2018) The role of prophylactic cranial irradiation in patients with extensive stage small cell lung cancer: a systematic review and meta-analysis. J\u00a0Thorac Oncol 13(6):840\u2013848. https:\/\/doi.org\/10.1016\/j.jtho.2018.02.024","journal-title":"J Thorac Oncol"},{"key":"2019_CR21","doi-asserted-by":"publisher","first-page":"876","DOI":"10.1007\/s00066-018-1307-1","volume":"194","author":"Y Chen","year":"2018","unstructured":"Chen\u00a0Y, Li\u00a0J, Zhang\u00a0Y et\u00a0al (2018) Early versus late prophylactic cranial irradiation in patients with extensive small cell lung cancer. Strahlenther Onkol 194:876\u2013885. https:\/\/doi.org\/10.1007\/s00066-018-1307-1","journal-title":"Strahlenther Onkol"},{"issue":"2","key":"2019_CR22","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1016\/j.annonc.2019.10.021","volume":"31","author":"AS Mansfield","year":"2020","unstructured":"Mansfield\u00a0AS, Ka\u017carnowicz\u00a0A, Karaseva\u00a0N et al (2020) Safety and patient-reported outcomes of atezolizumab, carboplatin, and etoposide in extensive-stage small-cell lung cancer (IMpower133): a\u00a0randomized phase I\/III trial. Ann Oncol 31(2):310\u2013317. https:\/\/doi.org\/10.1016\/j.annonc.2019.10.021","journal-title":"Ann Oncol"},{"issue":"10","key":"2019_CR23","doi-asserted-by":"publisher","first-page":"e2015748","DOI":"10.1001\/jamanetworkopen.2020.15748","volume":"3","author":"T Zhou","year":"2020","unstructured":"Zhou\u00a0T, Zhang\u00a0Z, Luo\u00a0F et al (2020) Comparison of first-line treatments for patients with extensive-stage small cell lung cancer: A systematic review and network meta-analysis. JAMA Netw Open 3(10):e2015748. https:\/\/doi.org\/10.1001\/jamanetworkopen.2020.15748","journal-title":"JAMA Netw Open"},{"issue":"1","key":"2019_CR24","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S1470-2045(20)30539-8","volume":"22","author":"JW Goldman","year":"2021","unstructured":"Goldman\u00a0JW, Dvorkin\u00a0M, Chen\u00a0Y et al (2021) Durvalumab, with or without tremelimumab, plus platinum-etoposide versus platinum-etoposide alone in first-line treatment of extensive-stage small-cell lung cancer (CASPIAN): updated results from a\u00a0randomised, controlled, open-label, phase 3 trial. Lancet Oncol 22(1):51\u201365. https:\/\/doi.org\/10.1016\/S1470-2045(20)30539-8","journal-title":"Lancet Oncol"},{"key":"2019_CR25","unstructured":"Leitlinienprogramm Onkologie (Deutsche Krebsgesellschaft, Deutsche Krebshilfe, AWMF) Pr\u00e4vention, Diagnostik, Therapie und Nachsorge des Lungenkarzinoms Langversion 2.01, 2022, AWMF-Registernummer: 020\/007OL. https:\/\/www.leitlinienprogramm-onkologie.de\/leitlinien\/lungenkarzinom. Accessed: 06.08.2022"}],"container-title":["Strahlentherapie und Onkologie"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-022-02019-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00066-022-02019-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-022-02019-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T16:03:19Z","timestamp":1687276999000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00066-022-02019-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,23]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["2019"],"URL":"https:\/\/doi.org\/10.1007\/s00066-022-02019-9","relation":{},"ISSN":["0179-7158","1439-099X"],"issn-type":[{"value":"0179-7158","type":"print"},{"value":"1439-099X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,23]]},"assertion":[{"value":"20 February 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 November 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"J.\u00a0Gn\u00fcchtel, D.\u00a0Vordermark, and D.\u00a0Medenwald declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Ethical approval was obtained from the ethics committee of the Martin Luther University Halle-Wittenberg (reference number: 2020-139). <i>Consent of publication:<\/i> not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}