A comparative study of the clinical efficacy and safety of combining chemotherapy with Hypofractionated and conventional fractionated radiotherapy for the treatment of limited-stage small cell lung cancer
WEI Haiyan
CAI Beibei
WEN Linchun
XIN Yong
Abstract：Objective To compare the differences in survival benefits,immune modulation,and safety of hypofractionated radiotherapy(HFRT)and conventional fractionated radiotherapy(CFRT)in patients with limited-stage small cell lung cancer(LS-SCLC)undergoing concurrent chemoradiotherapy.Methods A total of 80 treatment-native LS-SCLC patients admitted to Xuzhou Medical University Affiliated Suqian Hospital between March 2021 and September 2023 were included,which were divided into HFRT(n=40,3.0 Gy/time,total dose 54 Gy/18 times)and CFRT groups(n=40,2.0 Gy/time,total dose 60 Gy/30 times)according to the mode of radiotherapy.Both groups received cisplatin combined with etoposide chemotherapy,with radiotherapy initiated during the second chemotherapy cycle.Compared the median overall survival(OS)and progression-free survival(PFS);Dynamic changes in objective response rate(ORR),peripheral blood T-lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+ratio),serum tumor markers(ProGRP,VEGFR1,VEGFR2,NSE,ES);EORTC QLQ-C30 quality-of-life scores,and grade≥3 treatment-related toxicities between the two groups.Results With a median follow-up of 13.2 months;the HFRT group demonstrated superior median OS compared to CFRT group(12.38 vs.10.19 months;HR=0.62;95%CI 0.39-0.98;P=0.042);and there was no significant difference in ORR between the two groups(90.0%vs.82.5%;P=0.298).Immune analysis revealed post-treatment improvements in CD3+(56.3±7.2 vs.50.1±6.8),CD4+(38.5±5.4 vs.33.2±4.9),and CD4+/CD8+ratio(1.52±0.31 vs.1.29±0.28)in the HFRT group(P＜0.05).Quality-of-life scores were significantly higher in HFRT(83.6±6.2 vs.75.4±7.1;P=0.005).No statistically significant differences were observed in grade≥3 toxicities radiation esophagitis(27.5%vs.32.5%),pneumonitis(22.5%vs.25.0%),and hematologic toxicity(35.0%vs.40.0%)(P＞0.05).Conclusions For LS-SCLC treated with concurrent chemoradiotherapy;HFRT prolongs disease control duration,enhances cellular immune function,and improves quality of life without increasing severe treatment-related toxicities compared to CFRT,and provides an evidence-based rationale for optimizing radiotherapy fractionation regimens.
Keywords：Hypofractionated radiotherapyChemotherapyLimited-stage small cell lung cancerClinical efficacySafety study
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 168-172 )