ArticleDiscover oncology2025
Evaluating the role of consolidative chest radiotherapy after chemo-immunotherapy in extensive-stage small cell lung cancer: a retrospective study.
Article in Discover oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Narrative review of the staging classification controversy in stage N3 small cell lung cancer: from the perspective of overlapping Veterans Administration Lung Study Group and International Association for the Study of Lung Cancer definitions.Journal of thoracic disease · 2026Review
- Correction: Evaluating the role of consolidative chest radiotherapy after chemo‑immunotherapy in extensive‑stage small cell lung cancer: a retrospective study.Discover oncology · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
6 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundConsolidative chest radiotherapy (XRT) after chemoimmunotherapy may provide benefits in extensive-stage small cell lung cancer (ES-SCLC) due to the condition's high sensitivity to radiation. Current guidelines suggest chest XRT for patients with ES-SCLC who respond to chemotherapy, given its association with improved 2-year overall survival (OS), and reduced progression and recurrence rates. However, its role in the era of chemo-immunotherapy in ES-SCLC remains unclear. MATERIALS AND
methodsData from the National Cancer Database (NCDB) for patients diagnosed with ES-SCLC between 2017 and 2020 were analyzed (n = 24,676). Cases included those treated with multi-agent chemotherapy, with data for T, N, and M status, and chest XRT. Exclusion criteria included survival < 30 days, limited-stage SCLC cases, and missing key data elements. The primary outcome was OS from diagnosis, analyzed using Kaplan-Meier Methods and multi-variable Cox regression models. Propensity Score Matching (PSM) was performed to compare outcomes in ES-SCLC patients receiving chest XRT after immunotherapy versus immunotherapy alone, adjusting for T, N, and M status, institution, sex, and Charlson-Deyo score. A p-value of < 0.05 was considered statistically significant.
resultsThe study stratified patients in two stratums: 10,437 patients who received immunotherapy and 14,239 who did not receive immunotherapy. The proportion of chest XRT receivers was similar across both stratum (13% vs. 14%, p = 0.17). Receipt of XRT was significantly associated with younger age (< 70), female sex, T3-4 stage, N2-N3, and M1a status; (p < 0.05). Chest XRT was associated with significantly increased median OS in both stratum: immunotherapy (13.1 months vs. 9.8 months; p < 0.001) and non-immunotherapy (11.6 months vs. 8.4 months; p < 0.001). XRT was an independent predictor of better OS in both stratum after controlling for selected covariates (HR 0.72 and 0.67; p < 0.001). PSM analysis of 1,399 patients receiving XRT and immunotherapy and 1,399 receiving immunotherapy alone confirmed that XRT after immunotherapy was associated with improved OS (13.1 months vs. 9.4 months; HR 0.63, p < 0.001) with a 3-year survival of 16% (95%CI 13.7-18.3%) vs 7% (95% CI 5.3-8.7%), respectively.
conclusionOur analysis shows that consolidative chest XRT is associated with improved overall survival in patients with ES-SCLC in patients receiving immunotherapy. These findings are hypothesis-generating and support ongoing randomized studies evaluating consolidative radiotherapy in the chemoimmunotherapy era.
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