Precision treatment patterns and prognostic analysis: A retrospective study of small-cell lung cancer

In the past decade, the treatment methods for small-cell lung cancer (SCLC) have undergone advances and diversification. This study aimed to explore the treatment patterns of patients with SCLC and evaluate the efficacy of SCLC treatments in a real clinical setting.

This retrospective study included patients with limited-stage (LS) and extensive-stage (ES) SCLC who received treatment at Qingdao Central Hospital (Qingdao, China) from August 1, 2016, to April 30, 2023. The progression-free survival (PFS) and overall survival (OS) were evaluated for all enrolled patients and participant subgroups via Kaplan-Meier survival analysis.

A total of 83 and 117 patients with LS-SCLC and ES-SCLC, respectively, were enrolled. The median PFS and OS were 14.5 and 33.4 months for the LS-SCLC group and 9.8 and 20.1 months for the ES-SCLC group, respectively. First-line thoracic consolidative radiotherapy (TRT) and immune checkpoint inhibitors markedly prolonged the PFS in the ES-SCLC group (P = .023 and P = .045, respectively), whereas TRT alone significantly prolonged the OS (P = .036). PFS and OS were significantly prolonged in the LS-SCLC group in whom TRT was initiated during or before the second cycle of first-line chemotherapy (P = .031 and P = .041, respectively). Moreover, patients with at least three areas of lymph node metastasis had significantly poorer prognosis than those with fewer areas.

The patients in this study exhibited better prognosis than those in previous ones. TRT remains an important treatment that can improve the prognosis of patients with SCLC. However, new strategies are warranted for a more effective treatment.