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

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-09-06 DOI:10.1002/cam4.70175

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

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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.

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胸腔放疗对 ES-SCLC 患者一线治疗效果的影响。

背景：在广泛期小细胞肺癌（ES-SCLC）患者中，胸腔放疗（tRT）作为一线免疫疗法和化疗的辅助疗法的治疗优势仍不明确。我们试图通过一项回顾性队列研究，比较胸腔放疗与一线免疫疗法和化疗联合使用的有效性和安全性，来阐明这一问题：我们的回顾性研究纳入了2019年1月至2022年12月期间在华西医院接受治疗的ES-SCLC患者。他们接受了一线免疫治疗和化疗，并根据tRT的使用情况被分为两个队列。主要结果为总生存期（OS）和无进展生存期（PFS）。研究人员利用 Cox 回归分析确定了预后的潜在独立预测因素，并比较了不同患者亚组的治疗效果。使用Chi-squared检验比较了两组患者的治疗相关毒性：共有 99 名患者符合研究条件，其中 55 人接受了 tRT 治疗。随访时间为 39 个月。值得注意的是，与未接受 tRT 治疗的患者相比，接受 tRT 治疗的患者的 OS 和 PFS 均优于未接受 tRT 治疗的患者（P 结论：接受 tRT 治疗的患者的 OS 和 PFS 均优于未接受 tRT 治疗的患者）：因此，我们证实，在一线化疗和免疫治疗的传统方案中加入 tRT 可以获得更好的生存效果，而毒性不会显著增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.