Chemotherapy and Radiotherapy Regimens for Limited‐Stage Small Cell Lung Cancer Treated With Accelerated Hyperfractionated Radiotherapy Combined With Chemotherapy: A Real‐World Study
Junfeng Zhao, Jinquan Yao, Ying Li, Yingrui Bai, Chengxin LiuABSTRACT
Background
The standard treatment regimen for limited‐stage small cell lung cancer (LS‐SCLC) is 4–6 cycles of chemotherapy combined with thoracic radiotherapy. However, most patients still experience disease recurrence in a short period. Therefore, this study aims to evaluate the associations of different chemotherapy and radiotherapy strategies with survival outcomes.
Methods
This retrospective analysis included LS‐SCLC patients treated with chemotherapy and accelerated hyperfractionated radiotherapy. Progression‐free survival (PFS) served as the primary endpoint, while overall survival (OS) and brain metastasis‐free survival (BMFS) were evaluated as secondary endpoints.
Results
A total of 201 eligible patients were included. No significant survival difference was observed between patients receiving 4 cycles and those receiving 5–6 cycles of chemotherapy (HR: 0.83, 95% CI: 0.58–1.21, p = 0.332). Patients who received more than 45 Gy did not gain more survival benefit compared to those who received the standard 45 Gy dose, with median PFS of 13.1 and 13.9 months, respectively (HR: 1.43, 95% CI: 0.90–2.26, p = 0.125). This study found that radiotherapy interval > 75 days was associated with improved PFS compared with an interval ≤ 75 days (HR: 0.71, 95% CI: 0.48–0.97, p = 0.044).
Conclusion
For LS‐SCLC patients receiving accelerated hyperfractionated radiotherapy, higher total doses did not provide significant benefits compared to the standard dose (45 Gy/30 F). Although a radiotherapy interval > 75 days was associated with improved PFS and OS, this finding should be interpreted cautiously and requires prospective validation before being used to guide radiotherapy timing. Regarding chemotherapy, patients receiving 5–6 cycles of chemotherapy did not show significant benefits compared to those receiving 4 cycles.