ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Therapeutic strategies for elderly patients with unresectable limited-stage small cell lung cancer.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundElderly patients with limited-stage small cell lung cancer (LS-SCLC) are underrepresented in clinical trials, leading to a lack of evidence for optimal treatment strategies, especially for those with reduced tolerance for intensive concurrent chemoradiotherapy.
methodsThis retrospective cohort study analyzed 3,649 patients aged ≥75 years with unresectable LS-SCLC from the SEER database. Patients were categorized into active treatment (chemotherapy [C], radiotherapy [R], or both [C+R]) or palliative care groups. Propensity score matching (PSM) was used to minimize bias. Cancer-specific survival (CSS) and overall survival (OS) were compared, with subgroup analyses performed by T/N stage.
resultsActive treatment significantly was associated with median CSS (12 vs. 4 months, P<0.001) and OS (11 vs. 4 months, P<0.001) compared to palliative care. Among active treatments, C+R yielded the best outcomes (median CSS: 15 months). However, in early-stage disease (T1 or N0), radiotherapy alone (R) provided superior survival compared to chemotherapy alone (C) (T1: adjusted HR for CSS=0.554, P=0.001). Exploratory analysis indicated that for patients with lower disease burden (T1N0-2 or T2N0), survival with R alone was comparable to that with C+R (P>0.05), while C+R was superior for more advanced stages.
conclusionActive treatment should be considered for elderly LS-SCLC patients. Treatment intensity should be individualized based on disease stage and patient fitness. For patients with early-stage disease (T1N0-2, T2N0), radiotherapy alone appears to be an effective option, offering survival comparable to combined therapy without the added toxicity of chemotherapy. These findings highlight the need for stage-specific, patient-centered strategies in this population.
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