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. 2024 Sep;13(17):e70175.
doi: 10.1002/cam4.70175.

Impact of thoracic radiotherapy on first-line treatment outcomes in ES-SCLC patients

Xiaoli Mu  1 , Yixin Zhou  1 , Qing Liu  2 , Jiantao Wang  2 , Feng Xu  2 , Feng Luo  2 , Ke Wang  2 , Lu Li  2 , Panwen Tian  2 , Yalun Li  2 , Jiewei Liu  2 , Yan Zhang  2 , Jiyan Liu  1 , Yan Li  2
Affiliations

Impact of thoracic radiotherapy on first-line treatment outcomes in ES-SCLC patients

Xiaoli Mu et al. Cancer Med. 2024 Sep.

Abstract

Background: The therapeutic advantage of thoracic radiotherapy (tRT) as an adjunct to first-line immunotherapy and chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC) remains unclear. We sought to elucidate this in a retrospective cohort study comparing the effectiveness and safety of tRT in combination with first-line immunotherapy and chemotherapy.

Methods: Our retrospective study included patients with ES-SCLC, treated at the West China Hospital between January 2019 and December 2022. They received first-line immunotherapy and chemotherapy and were categorized into two cohorts based on the administration of tRT. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Cox regression analysis was utilized to identify potential independent predictors of prognosis and to compare the treatment outcomes across various patient subgroups. Treatment-related toxicities across both cohorts were compared using the Chi-squared test.

Results: A total of 99patients were eligible for the study, out of which 55 received tRT. The medianduration of follow-up was 39 months. Remarkably, patients who received tRTdemonstrated superior OS and PFS in comparison to those who did not (P < 0.05). Subgroup analysis further confirmed these findings. Multivariate analysisidentified treatment group and liver metastasis as independent prognosticfactors (P < 0.05). The incidence of grade 3-4 adverse events showed nostatistically significant difference between the two cohorts.

Conclusions: Thus, weconfirmed that the addition of tRT to the conventional regimen of first-linechemotherapy and immunotherapy yields better survival outcomes without asignificant increase in toxicity.

Keywords: Chemotherapy; Extensive‐stage small cell lung cancer; Immunotherapy; Survival outcomes; Thoracic radiotherapy.

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Conflict of interest statement

The authors have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Patient selection flow chart.
FIGURE 2
FIGURE 2
Kaplan–Meier(KM) curves of overall survival (A), progression‐free survival (B) in ES‐SCLC patients treated with tRT or without tRT.
FIGURE 3
FIGURE 3
KM curves for overall survival (A) and progression‐free survival (B) of ES‐SCLC patients treated with different radiation doses.
FIGURE 4
FIGURE 4
Swimmer plot of overall survival for patients who did not receive(A) or received(B) thoracic radiation therapy.
FIGURE 5
FIGURE 5
Forest plots for each subgroup analysis. (A) Forest plot for Overall Survival (OS). (B) Forest plot for Progression‐Free Survival (PFS).
See this image and copyright information in PMC

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