{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:45:42Z","timestamp":1787021142403,"version":"build-2736575974"},"reference-count":27,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[1999,9]]},"abstract":"<jats:p>PURPOSE: Because small-cell lung cancer is a rapidly proliferating tumor, it was hypothesized that it may be more responsive to thoracic irradiation (TI) given twice-daily than once-daily. This hypothesis was tested in a phase III trial.<\/jats:p>\n                  <jats:p>\n                    PATIENTS AND METHODS: Patients with limited-stage small-cell lung cancer were entered onto a phase III trial, and all patients initially received three cycles of etoposide (130 mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    \u2009\u00d7\u20093) and cisplatin (30 mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    \u2009\u00d7\u20093). Subsequently, patients who did not have progression to a distant site (other than brain) were randomized to twice-daily thoracic irradiation (TDTI) versus once-daily thoracic irradiation (ODTI) given concomitantly with two additional cycles of etoposide (100 mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    \u2009\u00d7\u20093) and cisplatin (30 mg\/m\n                    <jats:sup>2<\/jats:sup>\n                    \u2009\u00d7\u20093). The irradiation doses were TDTI, 48 Gy in 32 fractions, with a 2.5-week break after the initial 24 Gy, and ODTI, 50.4 Gy in 28 fractions. After thoracic irradiation, the patients received a sixth cycle of etoposide\/cisplatin, followed by prophylactic cranial irradiation (30 Gy\/15 fractions) if they had a complete response.\n                  <\/jats:p>\n                  <jats:p>RESULTS: Of 311 assessable patients enrolled in the trial, 262 underwent randomization to TDTI or ODTI. There were no differences between the two treatments with respect to local-only progression rates, overall progression rates, or overall survival. The patients who received TDTI had greater esophagitis (\u2265\u2009grade 3) than those who received ODTI (12.3% v 5.3%; P\u2009=\u2009.05). Although patients received thoracic irradiation encompassing the postchemotherapy volumes, only seven of 90 local failures were out of the portal of irradiation.<\/jats:p>\n                  <jats:p>CONCLUSION: When TI is delayed until the fourth cycle of chemotherapy, TDTI does not result in improvement in local control or survival compared with ODTI.<\/jats:p>","DOI":"10.1200\/jco.1999.17.9.2681","type":"journal-article","created":{"date-parts":[[2017,2,24]],"date-time":"2017-02-24T01:05:40Z","timestamp":1487898340000},"page":"2681-2681","source":"Crossref","is-referenced-by-count":177,"title":["Phase III Comparison of Twice-Daily Split-Course Irradiation Versus Once-Daily Irradiation for Patients With Limited Stage Small-Cell Lung Carcinoma"],"prefix":"10.1200","volume":"17","author":[{"given":"James A.","family":"Bonner","sequence":"first","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff A.","family":"Sloan","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Shanahan","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burke J.","family":"Brooks","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randolph S.","family":"Marks","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Krook","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James B.","family":"Gerstner","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Maksymiuk","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Levitt","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Mailliard","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry D.","family":"Tazelaar","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shauna","family":"Hillman","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Jett","sequence":"additional","affiliation":[{"name":"From the Mayo Clinic and Mayo Foundation, Rochester, and Duluth Community Clinical Oncology Program, Duluth, MN; Carle Cancer Center Community Clinical Oncology Program, Urbana, and Illinois Oncology Research Association Community Clinical Oncology Program, Peoria, IL; Oschner Community Clinical Oncology Program, New Orleans, LA; Saskatchewan Cancer Foundation (Saskatoon Cancer Centre, Saskatoon, and Allan Blair Cancer Centre, Regina, Saskatchewan, Canada); Meritcare Hospital Community Clinical Oncology..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"R1-2681","unstructured":"Morstyn  G,  Russo  A,  Carney  DN, et al: Heterogeneity in the radiation survival curves and biochemical properties of human lung cancer cell lines.  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