Bjørn Henning Grønberg, Norwegian University Of Science And Technology

💬 Biography
Specialist in medical and radiation oncology and have worked as a thoracic oncologist for 25 years.

Full professor at the Norwegian University of Science and Technology and Consultant at the Department of Oncology at St. Olavs hospital in Trondheim, Norway. The main activity of our group is clinical and translational small cell lung cancer research, including radiotherapy trials, but I have also done research on patient reported outcomes, patient information, geriatric oncology and brain tumors.

In addition, I am chairman of the Norwegian Lung Cancer Study Group, member of the IASLC Rare Tumors Committee and the Norwegian panel of experts for patients with a short life expectancy, which is a national second-opinion panel.

🎤 Presentation: Optimizing radiotherapy in combination treatment of SCLC
Overall, there have been significant improvement in lung cancer treatment the last decades, but not much for small cell lung cancer (SCLC). Recently, immune checkpoint inhibitors has become standard treatment of SCLC, but the survival benefit is limited for most patients. Thus, chemotherapy and radiotherapy remains the backbone of SCLC treatment.

While most agree on the medical treatment of SCLC, there appears to be different approaches in the use of radiotherapy, with respect to patient selection, indications and schedules. There have, however, been an encouraging increase in clinical SCLC research, including radiotherapy trials, which have generated data that might enable us to optimize radiation therapy of SCLC.

The most important application of radiotherapy is as part of primary, concurrent chemoradiotherapy of limited stage SCLC. Twice-daily thoracic RT of 45 Gy/30 fractions is the most recommended schedule, but only 1/3 of patients are cured. One reason for treatment failure is local intrathoracic relapse, and it has been hypothesized that higher RT doses improve local control and thereby survival. However, high-dose once-daily normofractionated RT does not prolong survival, but recent trials indicate that accelerated dose escalation might be a better approach.

The survival benefit of immunotherapy in ES SCLC is limited. It has long been hypothesized that radiotherapy can boost the effect of immunotherapy and several retrospective studies suggest that adding low-dose thoracic RT to chemoimmunotherapy improves survival. I will give an overview over the approaches being explored in ongoing randomized trials investigating whether there is an additive effect.

Prophylactic cranial irradiation (PCI) has been standard treatment for patients with LS who respond to chemoradiotherapy, but the role of PCI has become heavily debated due to concerns about toxicity. I will summarize data from recent trials that might be valuable for physicians and patients when discussing whether to give PCI.