BACKGROUND: Extensive-stage small cell lung cancer (ES-SCLC) is a malignant tumor with remarkable proliferative and invasive ability, which has very poor clinical prognosis due to lack of effective treatments. This study aims to evaluate the efficacy and synergistic effects of radiotherapy (RT) combined with immunotherapy (IT) and chemotherapy (CT) in patients with ES-SCLC. METHODS: A retrospective analysis was performed on 145 ES-SCLC patients treated with first-line CT. Kaplan-Meier analysis and Log-rank tests were used to evaluate survival outcomes, while propensity score matching (PSM) was applied to reduce confounding factors. RESULTS: The median overall survival (mOS) and median progression-free survival (mPFS) for the entire cohort were 15.7 and 6.9 mon, respectively. The IT+CT group had a significantly longer mOS compared to the CT group (17.2 vs 13.5 mon, P=0.047). Similarly, the RT+CT group demonstrated superior mOS (18.5 vs 12.3 mon, P<0.001) and mPFS (7.1 vs 6.2 mon, P=0.006) compared to the CT group. Multivariate analysis identified RT, IT, and Eastern Cooperative Oncology Group performance status (ECOG PS) as independent prognostic factors for mOS (P<0.05), while gender and ECOG PS were independent predictors for mPFS (P<0.05). Following PSM, the RT+CT group continued to exhibit significant advantages in mOS (18.0 vs 12.1 mon, P<0.001) and mPFS (7.1 vs 5.5 mon, P=0.037) compared to the CT group. Notably, the RT+IT+CT group achieved a markedly longer mOS than the IT+CT group (28.5 vs 15.8 mon, P=0.017). Grade 3-4 adverse events occurred in 27.6% of patients, with no grade 5 adverse events reported. CONCLUSIONS The combination of RT, IT, and CT significantly enhances the prognosis of ES-SCLC patients. RT plays a key role in their synergistic effects and demonstrates good safety, warranting further research and clinical application.
Humans ; Small Cell Lung Carcinoma/mortality* ; Male ; Female ; Middle Aged ; Lung Neoplasms/mortality* ; Retrospective Studies ; Aged ; Immunotherapy ; Prognosis ; Combined Modality Therapy ; Adult ; Neoplasm Staging ; Aged, 80 and over

Objective To evaluate the expression levels of peptidylarginine deiminase 4 (PADI4)and B-cells pecific Moloney leukemia virus insert site-1 (BMI-1 )in esophageal squamous cell carcinoma (ESCC) tissues and pericarcinous tissues.To explore the function and clinical significance in the development of ESCC and their association.Methods The expression levels of PADI4 and BMI-1 were measured by immunohisto-chemistry,Western blotting and quantitative real time PCR in ESCC tissues and pericarcinous tissues from 86 patients.The relationships between the expressions of PADI4 and BMI-1 and the clinicopathologic characte-ristics were analyzed.Results The immunohistochemistry showed that the expressions of PADI4 and BMI-1 in ESCC tissues (68.6% and 73.3%)were significantly higher than those in pericarcinous tissues (37.2% and 30.2%,χ2 =1 7.01 1 ,P =0.000;χ2 =31 .876,P =0.000).Western blotting indicated that the levels of PADI4 and BMI-1 were higher than those in pericarcinous tissues (0.91 9 ±0.098 vs.0.71 8 ±0.1 03,t =2.462,P =0.021 ;0.975 ±0.074 vs.0.71 7 ±0.071 ,t =2.640,P =0.01 4).The expressions of BMI-1 and PADI4 mRNA in ESCC tissues were higher than those in pericarcinous tissues,but the differences were not sta-tistically significant (0.091 ±0.005 vs.0.038 ±0.002,t =1 .701 ,P =0.1 01 ;0.1 1 4 ±0.075 vs.0.048 ± 0.003,t =1 .499,P =0.1 46)by the quantitative real time PCR.The expression of PADI4 was correlated with lymph node metastasis (χ2 =5.771 ,P =0.01 6),depth of invasion (χ2 =6.672,P =0.01 0)and clinical stage (χ2 =5.771 ,P =0.01 6).The BMI-1 gene expression had a correlation with lymph node metastasis (χ2 =7.1 76,P =0.007),the differentiation degree (χ2 =1 3.787,P =0.001 )and clinical stage (χ2 =7.1 76,P =0.007).In addition,there was a positive correlation between PADI4 and BMI-1 expression in ESCC by immunohistochemistry and quantitative real time PCR (r =0.21 4,P =0.047;r =0.534,P =0.005).Conclusion The expression levels of PADI4 and BMI-1 are significantly higher in ESCC compared to pericarcinous tissues.PADI4 and BMI-1 are positively correlated and may contribute to the diagnosis and prog-nosis of the ESCC.

As a kind of polyphenolic phytoalexin,resveratrol exerts protective roles in anti-tumor,antiinflammatory and promoting metabolism.Resveratrol's anti-tumor mechanisms may be involved in upregulating tumor suppressor microRNAs and downregulating oncogenic microRNAs,and affect its relative pathways and target genes in different cancers such as colon cancers and breast cancers.This will provide a new theoretical basis for the further clarification of resveratrol-associated tumor suppressing mechanisms and its application to the clinical.