ArticleFrontiers in endocrinology2026
An LDH-based prognostic model for extensive-stage small-cell lung cancer patients treated with chemo-immunotherapy and consolidative thoracic radiotherapy.
Article in Frontiers in endocrinology, 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
Background: Extensive-stage small-cell lung cancer (ES-SCLC) is a highly aggressive malignancy with poor long-term survival despite multimodal therapy. Endocrine and metabolic alterations have been increasingly recognized as contributors to tumor progression and potential prognostic indicators. Lactate dehydrogenase (LDH), a readily available biomarker reflecting tumor metabolic activity, has been associated with outcomes in various cancers. However, its prognostic significance in ES-SCLC patients receiving combined chemo-immunotherapy and consolidative thoracic radiotherapy remains unclear. Methods: Between 2019 and 2025, 81 stage III-IV ES-SCLC cases treated with chemo-immunotherapy and subsequent consolidative chest radiation were retrospectively reviewed. Clinical variables and blood biomarkers were collected. To evaluate prognosis, we employed Kaplan-Meier curves and Cox proportional hazards modeling. Having identified serum LDH as an autonomous prognostic marker through multivariate analysis, we categorized it using a clinical threshold of 250 U/L for in-depth study. Subsequently, we developed a prognostic nomogram for estimating OS at 1- and 2- years. Time-dependent ROC analysis conducted at the 12- and 24-mo nth marks was utilized to evaluate the model's discriminative power. Results: In total, 81 patients were included in the final analysis. Multivariable Cox regression demonstrated that serum LDH was independently associated with poorer overall survival (hazard ratio [HR] 1.006 per 1 U increase, 95% confidence interval [CI] 1.003-1.009; Conclusions: Our analysis indicates that serum LDH retains independent prognostic relevance for overall survival among ES-SCLC patients treated with combined chemo-immunotherapy and consolidative thoracic radiotherapy. The nomogram integrating LDH provided 1- and 2-year OS predictions, which may facilitate risk stratification and guide personalized management in the era of chemo-immunotherapy.
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