ArticleFrontiers in oncology2026
Salvage definitive or hypofractionated radiotherapy for oligometastatic recurrence after durvalumab consolidation in limited-stage small-cell lung cancer: a two-case report.
Article in Frontiers in oncology, 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
The ADRIATIC trial demonstrated that consolidation durvalumab after concurrent chemoradiotherapy (cCRT) improves progression-free survival (PFS) and overall survival (OS) in limited-stage small cell lung cancer (LS-SCLC), establishing a new standard of care. However, a proportion of patients still develop distant relapse, and optimal salvage strategies after immunotherapy remain unclear. While metastasis-directed radiotherapy, including stereotactic radiotherapy and hypofractionated radiotherapy, has shown benefit in selected oligometastatic non-small cell lung cancer (NSCLC), evidence in SCLC is limited. Here, we describe two LS-SCLC patients who developed limited metastatic relapse after cCRT followed by durvalumab consolidation: one with a solitary adrenal metastasis and the other with two brain metastases. Both patients received salvage radiotherapy (adrenal hypofractionated radiotherapy: 54 Gy in 15 fractions to GTV and 45 Gy in 15 fractions to PTV; brain lesions treated with whole-brain radiotherapy with simultaneous integrated boost [WBRT-SIB]: 40 Gy in 10 fractions to metastatic foci and 30 Gy in 10 fractions to the whole brain). Both patients experienced durable disease control exceeding four years without additional systemic therapy during follow-up. These two cases provide hypothesis-generating clinical observations suggesting that, in carefully selected LS-SCLC patients with limited metastatic relapse, curative-intent local radiotherapy may be feasible and warrants prospective evaluation.
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