Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysis

Background For extensive-stage small cell lung cancer (ES-SCLC) with intrathoracic residuals after chemotherapy, the landmark CREST trial demonstrated the benefit of consolidative thoracic radiotherapy (cTRT). Yet the efficacy and safety of cTRT after chemoimmunotherapy for ES-SCLC remain largely un...

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Main Authors: Nan Yao, Shuai Li, Lingling Hu, Yixian Pei, Zhaohui Qin, Na Li, Shaodong Tong, Nan Zhang, Yuanhu Yao
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Annals of Medicine
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Online Access:https://www.tandfonline.com/doi/10.1080/07853890.2025.2542434
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author Nan Yao
Shuai Li
Lingling Hu
Yixian Pei
Zhaohui Qin
Na Li
Shaodong Tong
Nan Zhang
Yuanhu Yao
author_facet Nan Yao
Shuai Li
Lingling Hu
Yixian Pei
Zhaohui Qin
Na Li
Shaodong Tong
Nan Zhang
Yuanhu Yao
author_sort Nan Yao
collection DOAJ
description Background For extensive-stage small cell lung cancer (ES-SCLC) with intrathoracic residuals after chemotherapy, the landmark CREST trial demonstrated the benefit of consolidative thoracic radiotherapy (cTRT). Yet the efficacy and safety of cTRT after chemoimmunotherapy for ES-SCLC remain largely unknown. This study aimed to assess the role of cTRT following chemoimmunotherapy in patients with ES-SCLC.Methods A retrospective analysis of ES-SCLC patients without disease progression after first-line chemoimmunotherapy was conducted between March 2019 and November 2021. Based on whether cTRT or not, patients were allocated to cTRT group or non-cTRT group. We evaluated efficacy by using the median overall survival (mOS) and progression-free survival (mPFS) times, and safety by measuring the incidence of adverse events.Results During this study, 72 patients with ES-SCLC were enrolled, with a median follow-up of 34.66 months. Twenty-nine patients received cTRT and 43 patients did not receive cTRT. Among the cTRT group and the non-cTRT group, the mPFS was 11.50 and 8.02 months, respectively, with a HR of 0.60 (95% CI 0.36–0.99, p = 0.043). The mOS in the cTRT group was also significantly longer than that in the non-cTRT group (28.68 months vs. 16.30 months, HR = 0.56, 95% CI 0.32–0.96, p = 0.033). Based on multivariate analysis, cTRT and cycles of immunotherapy ≥ 6 were independent factors affecting survival. There were no treatment-related deaths and most adverse events were grade 1–2.Conclusions This study suggests that the addition of cTRT to first-line chemo­immunotherapy significantly improves survival in ES-SCLC with well-tolerated toxicity.
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spelling doaj-art-e53563e40d6c48199165bc1b25a4b59e2025-08-20T03:43:14ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2542434Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysisNan Yao0Shuai Li1Lingling Hu2Yixian Pei3Zhaohui Qin4Na Li5Shaodong Tong6Nan Zhang7Yuanhu Yao8Department of Radiation Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, ChinaDepartment of Radiation Oncology, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, ChinaDepartment of Hematology, Ruijin Hospital Wuxi Branch, Shanghai Jiao Tong University School of Medicine, Wuxi, Jiangsu, ChinaDepartment of Radiation Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, ChinaResearch Center for Medical and Health Emergency Rescue, Xuzhou Medical University, Xuzhou, Jiangsu, ChinaDepartment of Radiation Oncology, Xuzhou Central Hospital, Xuzhou, Jiangsu, ChinaDepartment of Radiation Oncology, Xuzhou Cancer Hospital, Xuzhou, Jiangsu, ChinaDepartment of Pulmonary and Critical Care Medicine, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi, Jiangsu, ChinaDepartment of Radiation Oncology, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi, Jiangsu, ChinaBackground For extensive-stage small cell lung cancer (ES-SCLC) with intrathoracic residuals after chemotherapy, the landmark CREST trial demonstrated the benefit of consolidative thoracic radiotherapy (cTRT). Yet the efficacy and safety of cTRT after chemoimmunotherapy for ES-SCLC remain largely unknown. This study aimed to assess the role of cTRT following chemoimmunotherapy in patients with ES-SCLC.Methods A retrospective analysis of ES-SCLC patients without disease progression after first-line chemoimmunotherapy was conducted between March 2019 and November 2021. Based on whether cTRT or not, patients were allocated to cTRT group or non-cTRT group. We evaluated efficacy by using the median overall survival (mOS) and progression-free survival (mPFS) times, and safety by measuring the incidence of adverse events.Results During this study, 72 patients with ES-SCLC were enrolled, with a median follow-up of 34.66 months. Twenty-nine patients received cTRT and 43 patients did not receive cTRT. Among the cTRT group and the non-cTRT group, the mPFS was 11.50 and 8.02 months, respectively, with a HR of 0.60 (95% CI 0.36–0.99, p = 0.043). The mOS in the cTRT group was also significantly longer than that in the non-cTRT group (28.68 months vs. 16.30 months, HR = 0.56, 95% CI 0.32–0.96, p = 0.033). Based on multivariate analysis, cTRT and cycles of immunotherapy ≥ 6 were independent factors affecting survival. There were no treatment-related deaths and most adverse events were grade 1–2.Conclusions This study suggests that the addition of cTRT to first-line chemo­immunotherapy significantly improves survival in ES-SCLC with well-tolerated toxicity.https://www.tandfonline.com/doi/10.1080/07853890.2025.2542434Chemoimmunotherapyconsolidative thoracic radiotherapyextensive-stage small cell lung cancerefficacysafety
spellingShingle Nan Yao
Shuai Li
Lingling Hu
Yixian Pei
Zhaohui Qin
Na Li
Shaodong Tong
Nan Zhang
Yuanhu Yao
Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysis
Annals of Medicine
Chemoimmunotherapy
consolidative thoracic radiotherapy
extensive-stage small cell lung cancer
efficacy
safety
title Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysis
title_full Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysis
title_fullStr Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysis
title_full_unstemmed Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysis
title_short Consolidative thoracic radiotherapy improves the prognosis of extensive stage small-cell lung cancer patients in the chemoimmunotherapy era: a multicenter retrospective analysis
title_sort consolidative thoracic radiotherapy improves the prognosis of extensive stage small cell lung cancer patients in the chemoimmunotherapy era a multicenter retrospective analysis
topic Chemoimmunotherapy
consolidative thoracic radiotherapy
extensive-stage small cell lung cancer
efficacy
safety
url https://www.tandfonline.com/doi/10.1080/07853890.2025.2542434
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