Chemoradioimmunotherapy versus chemoimmunotherapy or chemoradiotherapy in extensive-stage small-cell lung cancer: A retrospective analysis of survival outcomes

Abstract

Background and purpose: Current evidence is insufficient to define the value of thoracic radiotherapy (TRT) following chemoimmunotherapy (CT-IO) in extensive-stage small-cell lung cancer (ES-SCLC). We aimed to ascertain whether incorporating immunotherapy (IO) could improve survival and explore the efficacy of TRT in combination with CT-IO among patients with ES-SCLC.

Methods: Clinical data were retrospectively analyzed. Patients were classified into two groups: IO and chemoradiotherapy (CRT). Within the IO group, we further defined two subgroups: CT-IO and chemoradioimmunotherapy (CRT-IO) groups.

Results: A total of 206 patients were enrolled in this study. The median overall survival was 22.2 months in the CRT-IO group, which was longer than the 16.0 months observed in the CT-IO group (P = 0.002) and 19.0 months noted in the CRT group (P = 0.208). The objective response rate (ORR) in the CRT-IO group (69.8%) was better than that in the CT-IO (68.9 %, P = 0.929) and CRT (59.3 %, P = 0.227) groups.

Conclusions: Considering the trend toward prolonged survival and a higher ORR in the CRT-IO group, TRT may be feasible in IO era. Considering the economic factors and physical conditions, CRT may be an option for patients with ES-SCLC.

Keywords

chemoimmunotherapy / chemoradioimmunotherapy / chemoradiotherapy / extensive-stage small cell lung cancer

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2025 The Author(s). Precision Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Shandong Cancer Hospital & Institute.