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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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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author Haojun Wang MM
Huiru Zhang MM
Yan Yao MD
Yang Yu MD
Longyun Wang MD
Ruijuan Liu MD
Changgang Sun PhD
Jing Zhuang PhD
author_facet Haojun Wang MM
Huiru Zhang MM
Yan Yao MD
Yang Yu MD
Longyun Wang MD
Ruijuan Liu MD
Changgang Sun PhD
Jing Zhuang PhD
author_sort Haojun Wang MM
collection DOAJ
description 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.
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series Cancer Control
spelling doaj-art-2566ff53b33942d4a1264e02ed7eddc82025-08-20T03:37:22ZengSAGE PublishingCancer Control1526-23592025-05-013210.1177/10732748251347679Which 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 CohortHaojun Wang MMHuiru Zhang MMYan Yao MDYang Yu MDLongyun Wang MDRuijuan Liu MDChanggang Sun PhDJing Zhuang PhDIntroduction 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.https://doi.org/10.1177/10732748251347679
spellingShingle Haojun Wang MM
Huiru Zhang MM
Yan Yao MD
Yang Yu MD
Longyun Wang MD
Ruijuan Liu MD
Changgang Sun PhD
Jing Zhuang PhD
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
Cancer Control
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url https://doi.org/10.1177/10732748251347679
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