{"entity":{"id":"turrisi-intergroup-0096","kind":"trial","name":"Intergroup 0096 (Turrisi): twice-daily versus once-daily thoracic radiotherapy","aka":["INT 0096","Turrisi trial"],"tldr":"Showed that giving the same dose of radiotherapy twice a day for three weeks, rather than once a day for five, raises the five-year survival of limited-stage small-cell lung cancer from 16 to 26 percent.","summary":"Thoracic radiotherapy was known to improve survival in limited-stage small-cell lung cancer, but how to fit it around chemotherapy was unsettled. Intergroup 0096 gave all 417 patients four 21-day cycles of cisplatin and etoposide and randomised them to 45 Gy of concurrent thoracic radiotherapy given either twice daily over three weeks or once daily over five, both starting with cycle 1.\n\nAfter a median follow-up of almost eight years, median survival was 23 months with twice-daily treatment against 19 months with once-daily (log-rank p=0.04). Two-year survival was 47 against 41 percent and five-year survival 26 against 16 percent. Grade 3 oesophagitis was the price: 27 percent against 11 percent.\n\nThe combined two- and five-year survival of 44 and 23 percent was a considerable advance on the previous literature, and twice-daily 45 Gy has been a standard ever since, although many centres use 60 to 66 Gy once daily instead because CONVERT, which compared 45 Gy twice daily with 66 Gy once daily in 547 patients, found no significant survival difference and similar toxicity.","status":"positive","asOf":"2026-09-25","links":[{"label":"Intergroup 0096 (New England Journal of Medicine 1999)","url":"https://doi.org/10.1056/NEJM199901283400403"}],"tags":[],"related":[],"cancers":["limited-stage-sclc"],"sections":[],"technologies":["imrt-igrt","hypofractionated-radiotherapy","cytotoxic-chemotherapy","platinum"],"targets":[],"drugs":["cisplatin","etoposide","platinum-etoposide"],"companies":[],"institutions":[],"pathways":[],"terms":["chemoradiation","curative-intent"],"trials":["convert","adriatic"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"phase":"3","setting":"Limited-stage small-cell lung cancer: 45 Gy of concurrent thoracic radiotherapy delivered twice daily over three weeks versus once daily over five weeks, both starting with cycle 1 of four cycles of cisplatin and etoposide, with overall survival as the primary endpoint","sponsor":"Eastern Cooperative Oncology Group and the North American intergroup","result":"Median survival 23 against 19 months (p=0.04); five-year survival 26 against 16 percent; grade 3 oesophagitis 27 against 11 percent.","yearReported":1999,"enrolled":417,"enrolledBasis":"randomised","enrolledNote":"417 patients were randomised; the trial predates ClinicalTrials.gov registration.","outcomes":[{"endpoint":"Overall survival at 5 years","primary":true,"unit":"%","arms":[{"name":"45 Gy twice daily over 3 weeks","value":26},{"name":"45 Gy once daily over 5 weeks","value":16}],"p":"0.04","source":"https://doi.org/10.1056/NEJM199901283400403"},{"endpoint":"Grade 3 oesophagitis","unit":"%","arms":[{"name":"45 Gy twice daily over 3 weeks","value":27},{"name":"45 Gy once daily over 5 weeks","value":11}],"source":"https://doi.org/10.1056/NEJM199901283400403"}],"replication":"CONVERT found 45 Gy twice daily and 66 Gy once daily gave similar survival and toxicity, so both schedules are used."},"route":"/trials/turrisi-intergroup-0096/","neighbours":{"cancer":[{"id":"limited-stage-sclc","kind":"cancer","name":"Limited-stage small-cell lung cancer","route":"/cancers/limited-stage-sclc/"},{"id":"lung-cancer","kind":"cancer","name":"Lung cancer (all types)","route":"/cancers/lung-cancer/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"hypofractionated-radiotherapy","kind":"technology","name":"Hypofractionated radiotherapy","route":"/technologies/hypofractionated-radiotherapy/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"platinum","kind":"technology","name":"Platinum agents","route":"/technologies/platinum/"}],"drug":[{"id":"cisplatin","kind":"drug","name":"Cisplatin","route":"/drugs/cisplatin/"},{"id":"etoposide","kind":"drug","name":"Etoposide","route":"/drugs/etoposide/"},{"id":"platinum-etoposide","kind":"drug","name":"Platinum + etoposide (EP / CE)","route":"/drugs/platinum-etoposide/"}],"term":[{"id":"chemoradiation","kind":"term","name":"Chemoradiation (chemoradiotherapy, CRT)","route":"/terms/chemoradiation/"},{"id":"curative-intent","kind":"term","name":"Curative intent vs palliative intent","route":"/terms/curative-intent/"}],"trial":[{"id":"adriatic","kind":"trial","name":"ADRIATIC","route":"/trials/adriatic/"},{"id":"convert","kind":"trial","name":"CONVERT","route":"/trials/convert/"}]}}