Efficacy and toxicity analysis of thoracic radiotherapy for extensive-stage small cell lung cancer patients after first-line chemoimmunotherapy
10.3760/cma.j.cn113030-20231126-00179
- VernacularTitle:广泛期SCLC一线化学免疫联合治疗后放疗的疗效及不良反应
- Author:
Chaonan ZHANG
1
;
Wenqing WANG
;
Zongmei ZHOU
;
Lei DENG
;
Nan BI
;
Tao ZHANG
;
Jianyang WANG
;
Xin WANG
;
Wenyang LIU
;
Zefen XIAO
;
Jima LYU
;
Yirui ZHAI
;
Qinfu FENG
Author Information
1. 国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院放疗科，北京 100021
- Keywords:
Small cell lung carcinoma, extensive stage;
Radiotherapy;
Immunotherapy;
Treatment outcome;
Adverse effects
- From:
Chinese Journal of Radiation Oncology
2024;33(8):703-710
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and efficacy of thoracic radiotherapy (TRT) for extensive-stage small cell lung cancer (ES-SCLC) patients in the era of first-line chemoimmunotherapy.Methods:Medical records of 56 patients with ES-SCLC who received thoracic radiotherapy after first-line platinum-based chemotherapy plus immunotherapy in Cancer Hospital Chinese Academy of Medical Sciences from January 2018 to December 2021 were retrospectively analyzed. The control group was not established for clinical causes. The overall survival (OS), progression-free survival (PFS) and local recurrence-free survival (LRFS) were calculated using the Kaplan-Meier method. Univariate and multivariate analyses were employed to identify prognostic factors using the Cox proportional hazards model. The cumulative incidence of local regional recurrence (LRR) was estimated using the Fine-Grey competing risks regression model.Results:Among 56 patients in our cohort, 47 patients received consolidative TRT (cTRT) before progression and 9 patients received salvage TRT after progression. The median follow-up time was 21 months (95% CI=19.8-22.2 months), the median OS was not reached, the median PFS was 9 months (95% CI=7.0-13.0 months), and the 1-year and 18-month OS rates were 84.9%, 62.1%. In the cTRT group, the 1-year and 18-month OS rates were 84.1%, 64.5%, with the median PFS of 10 months; 1-year and 18-month LRFS rates were 73.6% and 66.0%, respectively; the cumulative incidence of LRR at 1-year and 2-year were 24.9% and 30.8%, respectively. No other 4-5 grade adverse events (AE) were reported except 6 patients presenting with 4 grade hematologic toxicities. Three grade radiation esophagitis occurred in 3 patients (5%). Ten patients (18%) developed 1-2 grade treatment-related pneumonitis, including 5 (9%) patients with immune related pneumonitis and 5 (9%) patients with radiation pneumonitis. Conclusion:The application of TRT after first-line chemoimmunotherapy is safe and may has potential survival benefit for patients with ES-SCLC.
