Evidence map›Paper›PMID 39500635›Full record

ArticleCNS neuroscience & therapeutics2024

The Optimal Radiotherapy Strategy for Patients With Small Cell Lung Cancer and Brain Metastasis: A Retrospective Analysis.

Qian Zeng, Xianjing Chu, Gang Xiao, Jing Zhang, Yingying Zhang, Bin Long, Lei Yang, Zhaohua Tan, Rongrong Zhou

Abstract read
In one paragraph

Article in CNS neuroscience & therapeutics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Qian ZengDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Xianjing ChuDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Gang XiaoDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Jing ZhangDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Yingying ZhangDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Bin LongDepartment of Oncology, Xiangya Boai Hospital, Changsha, China.
Lei YangDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Zhaohua TanDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.
Rongrong ZhouDepartment of Oncology, Xiangya Hospital, Central South University, Changsha, China.ORCID 0000-0003-4483-0615

Funding

Advanced Lung Cancer Targeted Therapy Research Foundation of China CTONG-YC20210303Chen Xiao-Ping Foundation for the Development of Science and Technology of Hubei Province CXPJJH121005-01Clinical Research Special Fund of Wu Jieping Medical Foundation 320.6750.2023-5-109National Multidisciplinary Cooperative Diagnosis and Treatment Capacity z027002
6 · The paper itself

Abstract

backgroundExtensive-stage small cell lung cancer (ES-SCLC) is a notoriously aggressive malignancy frequently associated with brain metastases (BMs), presenting substantial therapeutic challenges. This study delves into the effectiveness of immunotherapy combined with diverse radiotherapy, especially the influence of brain radiotherapy (BRT) on survival outcomes in the immunotherapy era.

methodsES-SCLC patients treated at Xiangya Hospital and Xiangya Boai Hospital from February 2020 to June 2024 were retrospectively included. The study focused on patients receiving immune checkpoint inhibitors (ICIs). Metrics included overall survival (OS) and progression-free survival (PFS), employing univariate and multivariate Cox regression models for statistical analysis.

resultsA total of 393 patients with ES-SCLC who received ICIs were included in the study. Within the entire cohort, the presence of baseline BMs did not statistically affect OS or PFS. However, thoracic radiotherapy (TRT) was identified as a favorable prognostic factor for both OS and PFS. BRT demonstrated a beneficial effect on OS across both the general cohort and the baseline_BMs subgroup. In patients from the baseline_BMs subgroup who had previously undergone TRT, ICIs plus BRT did not significantly improve OS compared to ICIs alone. Conversely, for patients who had not received prior TRT, adding BRT to ICIs significantly enhanced OS. Among the patients who underwent BRT, 71 received whole brain radiotherapy (WBRT) while 19 opted for stereotactic radiosurgery (SRS). No significant differences in OS and PFS were observed between the SRS and WBRT modalities. The sequence of ICIs relative to BRT was found to influence PFS adversely. Administering BRT before ICIs (RT-ICI) was associated with worse PFS compared to administering ICIs followed by BRT (ICI-RT). Additionally, no significant differences in OS and PFS were noted among the three subgroups defined by varying intervals between ICIs and BRT. For patients without baseline BMs, TRT and prophylactic cranial irradiation were associated with delayed onset of brain metastases.

conclusionsOur study underscores the importance of optimizing treatment strategies and considering the timing and integration of radiotherapy and immunotherapy to improve outcomes for patients with ES-SCLC, particularly those at risk of or presenting with BMs.

Indexed as

Brain NeoplasmsLung NeoplasmsSmall Cell Lung CarcinomaAdultAgedAged, 80 and overCranial IrradiationFemaleHumansImmune Checkpoint InhibitorsMaleMiddle AgedRetrospective StudiesImmune Checkpoint Inhibitorsbrain metastasesbrain radiotherapyextensive‐stage small cell lung cancerimmune checkpoint inhibitors

Identifiers

PMID39500635
PMCPMC11537770

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.