Which Types of Patients With Extensive-Stage Small Cell Lung Cancer Benefit From Radiotherapy? A Retrospective Study Integrating Machine Learning With the SEER Database and a Chinese Cohort

Introduction Accurate machine learning-based prognostic models for the diagnosis and treatment of extensive-stage small cell lung cancer (ES-SCLC) are currently lacking, and the role of radiotherapy in ES-SCLC remains a subject of ongoing debate. Methods This study used data from the Surveillance, E...

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Bibliographic Details
Main Authors: Haojun Wang MM, Huiru Zhang MM, Yan Yao MD, Yang Yu MD, Longyun Wang MD, Ruijuan Liu MD, Changgang Sun PhD, Jing Zhuang PhD
Format: Article
Language:English
Published: SAGE Publishing 2025-05-01
Series:Cancer Control
Online Access:https://doi.org/10.1177/10732748251347679
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Summary:Introduction Accurate machine learning-based prognostic models for the diagnosis and treatment of extensive-stage small cell lung cancer (ES-SCLC) are currently lacking, and the role of radiotherapy in ES-SCLC remains a subject of ongoing debate. Methods This study used data from the Surveillance, Epidemiology, and End Results (SEER) database of patients diagnosed with ES-SCLC. Cox regression analysis was performed to identify the key prognostic factors. Six machine learning models were developed: XGBoost, support vector machine, k-nearest neighbors, random forest, Iterative Dichotomiser 3, and logistic regression. External validation was conducted using the medical records of ES-SCLC patients who met the screening criteria at a local hospital. Propensity score matching was applied to address baseline imbalance. Kaplan–Meier (K-M) survival analysis was used to evaluate the prognostic impact of radiotherapy, followed by stratified K-M analysis to further explore its applicability across subgroups. Results The analysis revealed that radiotherapy, chemotherapy, and liver metastasis were significantly associated with prognosis ( P < .001). Liver metastasis was an independent risk factor of poor survival. The stratified K-M analysis suggested that radiotherapy may benefit certain patient subgroups. Conclusion This study provides novel insights into radiotherapy indications for ES-SCLC, contributing to improved clinical guidelines and treatment strategies based on machine learning-derived prognostic models.
ISSN:1526-2359