The effects and toxicity profiles of consolidative and salvage thoracic radiotherapy following chemoimmunotherapy in patients with extensive-stage small cell lung cancer
Ruozhou Sun
Dan Zong
Xin Chen
Yizhi Ge
Ning Jiang
Lijun Zhao
Xue Song
Xia He
Xiangzhi Zhu
Abstract：The present study assessed the efficacy and safety of thoracic radiotherapy (TRT) following first-line chemotherapy or chemoimmunotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC), focusing on the influence of different TRT timing strategies (consolidative vs. salvage) on survival rates. We retrospectively analyzed a total of 54 patients with ES-SCLC treated between January 2019 and July 2022. Patients receiving consolidative TRT (cTRT) within three months after completion of first-line treatment were compared with those receiving salvage TRT (sTRT) after disease progression. The primary endpoints were overall survival (OS), progression-free survival (PFS), locoregional-free survival (LRFS), and distant metastasis-free survival (DMFS); the secondary endpoint included safety. The cTRT group (n=41) showed significantly longer median OS (26.6 vs. 14.8 months, P=0.048), PFS (12.9 vs. 3.5 months, P<0.0001), and DMFS (10.7 vs. 3.4 months, P=0.0044) than the sTRT group (n=13). Multivariate analysis revealed that cTRT was an independent, favorable prognostic factor. No significant differences in OS or LRFS were observed between high-dose (≥ 50 Gy) and low-dose (< 50 Gy) TRT. Hematologic and respiratory toxicities were the most frequently reported adverse events, with acceptable tolerability. In conclusion, cTRT after chemoimmunotherapy significantly improves survival outcomes for ES-SCLC patients, and low-dose TRT may be a suitable option.
Keywords：extensive-stage small cell lung cancerthoracic radiotherapychemoimmunotherapysurvival ratesafety
Publication Date：2025-09-30
Online Publishing Date：2025-12-01(First online date of this platform, not the publication date of the document)
Pages：11( 467-477 )