National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era
Purpose: Small cell lung cancer (SCLC) is a highly aggressive form of lung cancer that often leads to brain metastases. Traditional treatment has largely relied on whole brain radiation therapy (WBRT). However, concerns about neurocognitive side effects have led to the adoption of advanced technique...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-03-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109425000089 |
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| author | Jay Desai, BA Sujay Rajkumar, BS Matthew J. Shepard, MD Rodney E. Wegner, MD |
| author_facet | Jay Desai, BA Sujay Rajkumar, BS Matthew J. Shepard, MD Rodney E. Wegner, MD |
| author_sort | Jay Desai, BA |
| collection | DOAJ |
| description | Purpose: Small cell lung cancer (SCLC) is a highly aggressive form of lung cancer that often leads to brain metastases. Traditional treatment has largely relied on whole brain radiation therapy (WBRT). However, concerns about neurocognitive side effects have led to the adoption of advanced techniques such as hippocampal avoidance WBRT (HA-WBRT) and stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study used data from the National Cancer Database spanning from 2010 to 2021. The study included adult patients diagnosed with brain metastases from SCLC who received primary radiation therapy directed at the brain. Patients were categorized into 3 treatment groups: WBRT, HA-WBRT, and SRS. Statistical analyses, including logistic regression, Kaplan–Meier survival analysis, and Cox regression, were performed to identify predictors of treatment type and survival outcomes. Results: The study analyzed 24,858 patients with a median age of 65 years. Over time, there was a significant increase in the use of advanced radiation techniques (HA-WBRT and SRS). SRS and HA-WBRT were associated with longer median survival (10.6 and 10.1 months, respectively) than WBRT (7.3 months). Factors such as advanced age, extracranial disease, and higher comorbidity scores were linked to poorer survival, whereas the use of chemotherapy, immunotherapy, and higher socioeconomic status were associated with improved outcomes. Conclusions: From 2010 to 2021, there has been an increase in the use of more advanced techniques to treat brain metastasis from SCLC. These advanced techniques were associated with improved survival outcomes, although selection bias and the retrospective nature of the study limit definitive conclusions. |
| format | Article |
| id | doaj-art-b2dea6eb8aa04de58aa5c2011a2eaae9 |
| institution | DOAJ |
| issn | 2452-1094 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj-art-b2dea6eb8aa04de58aa5c2011a2eaae92025-08-20T02:43:43ZengElsevierAdvances in Radiation Oncology2452-10942025-03-0110310172010.1016/j.adro.2025.101720National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern EraJay Desai, BA0Sujay Rajkumar, BS1Matthew J. Shepard, MD2Rodney E. Wegner, MD3Drexel University College of Medicine, Philadelphia, PennsylvaniaDrexel University College of Medicine, Philadelphia, PennsylvaniaDepartment of Neurosurgery, Allegheny Health Network, Pittsburgh, PennsylvaniaDepartment of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, Pennsylvania; Corresponding author: Rodney Wegner, MDPurpose: Small cell lung cancer (SCLC) is a highly aggressive form of lung cancer that often leads to brain metastases. Traditional treatment has largely relied on whole brain radiation therapy (WBRT). However, concerns about neurocognitive side effects have led to the adoption of advanced techniques such as hippocampal avoidance WBRT (HA-WBRT) and stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study used data from the National Cancer Database spanning from 2010 to 2021. The study included adult patients diagnosed with brain metastases from SCLC who received primary radiation therapy directed at the brain. Patients were categorized into 3 treatment groups: WBRT, HA-WBRT, and SRS. Statistical analyses, including logistic regression, Kaplan–Meier survival analysis, and Cox regression, were performed to identify predictors of treatment type and survival outcomes. Results: The study analyzed 24,858 patients with a median age of 65 years. Over time, there was a significant increase in the use of advanced radiation techniques (HA-WBRT and SRS). SRS and HA-WBRT were associated with longer median survival (10.6 and 10.1 months, respectively) than WBRT (7.3 months). Factors such as advanced age, extracranial disease, and higher comorbidity scores were linked to poorer survival, whereas the use of chemotherapy, immunotherapy, and higher socioeconomic status were associated with improved outcomes. Conclusions: From 2010 to 2021, there has been an increase in the use of more advanced techniques to treat brain metastasis from SCLC. These advanced techniques were associated with improved survival outcomes, although selection bias and the retrospective nature of the study limit definitive conclusions.http://www.sciencedirect.com/science/article/pii/S2452109425000089 |
| spellingShingle | Jay Desai, BA Sujay Rajkumar, BS Matthew J. Shepard, MD Rodney E. Wegner, MD National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era Advances in Radiation Oncology |
| title | National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era |
| title_full | National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era |
| title_fullStr | National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era |
| title_full_unstemmed | National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era |
| title_short | National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era |
| title_sort | national trends in radiation treatment for small cell lung cancer brain metastases in the modern era |
| url | http://www.sciencedirect.com/science/article/pii/S2452109425000089 |
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