PDF(Pubmed)
Abstract：
UNASSIGNED: Immunotherapy has greatly increased the survival time of patients with extensive-stage small cell lung cancer (ES-SCLC), and is now a standard first-line treatment for these patients. Increasing evidence suggests a possible synergistic effect between immunotherapy and radiotherapy, yet there is a paucity of evidence regarding the efficacy and safety of thoracic radiotherapy (TRT) combined with chemo-immunotherapy for ES-SCLC.
UNASSIGNED: The medical records of 78 consecutive patients with ES-SCLC who received TRT in combination with chemo-immunotherapy at Jinling Hospital and Jiangsu Cancer Hospital from January 2019 to January 2023 were retrospectively reviewed. The median overall survival (mOS) time and median progression-free survival (mPFS) time were used to evaluate efficacy, and the incidence of adverse events (AEs) was used to evaluate safety.
UNASSIGNED: The median follow-up time was 31.9 months, the objective response rate (ORR) was 59%, and the disease control rate (DCR) was 89.8%. The mOS time was 20.0 months, and the 6-month OS rate was 95%. The mPFS time was 9.2 months, and the 6-month PFS rate was 78%. There were no treatment-related deaths. The incidence of pneumonitis was 23.1%, the incidence of radiation esophagitis was 5.1%, and 2 patients experienced high-grade pneumonitis. Primary liver metastasis was a predictor of poor OS and PFS. Patients who received consolidative TRT after chemo-immunotherapy experienced more benefit than those who received TRT as palliative or salvage treatment for superior vena cava syndrome or disease progression.
UNASSIGNED: TRT is a feasible treatment for patients who receive chemo-immunotherapy for the management of ES-SCLC in consideration of its considerable efficacy and tolerable safety risk. This treatment is especially useful for patients without primary liver metastasis and who receive consolidative TRT after chemo-immunotherapy. Large-scale prospective studies are needed to confirm the efficacy and safety of this treatment modality.
UNASSIGNED: The medical records of 78 consecutive patients with ES-SCLC who received TRT in combination with chemo-immunotherapy at Jinling Hospital and Jiangsu Cancer Hospital from January 2019 to January 2023 were retrospectively reviewed. The median overall survival (mOS) time and median progression-free survival (mPFS) time were used to evaluate efficacy, and the incidence of adverse events (AEs) was used to evaluate safety.
UNASSIGNED: The median follow-up time was 31.9 months, the objective response rate (ORR) was 59%, and the disease control rate (DCR) was 89.8%. The mOS time was 20.0 months, and the 6-month OS rate was 95%. The mPFS time was 9.2 months, and the 6-month PFS rate was 78%. There were no treatment-related deaths. The incidence of pneumonitis was 23.1%, the incidence of radiation esophagitis was 5.1%, and 2 patients experienced high-grade pneumonitis. Primary liver metastasis was a predictor of poor OS and PFS. Patients who received consolidative TRT after chemo-immunotherapy experienced more benefit than those who received TRT as palliative or salvage treatment for superior vena cava syndrome or disease progression.
UNASSIGNED: TRT is a feasible treatment for patients who receive chemo-immunotherapy for the management of ES-SCLC in consideration of its considerable efficacy and tolerable safety risk. This treatment is especially useful for patients without primary liver metastasis and who receive consolidative TRT after chemo-immunotherapy. Large-scale prospective studies are needed to confirm the efficacy and safety of this treatment modality.
摘要：
■免疫治疗大大增加了广泛期小细胞肺癌（ES-SCLC）患者的生存时间，现在是这些患者的标准一线治疗方法。越来越多的证据表明，免疫治疗和放疗之间可能存在协同作用，然而,关于胸部放疗(TRT)联合化疗免疫疗法治疗ES-SCLC的有效性和安全性的证据很少.
■回顾性分析2019年1月至2023年1月在金陵医院和江苏省肿瘤医院接受TRT联合化学免疫治疗的78例ES-SCLC患者的病历。采用中位总生存期(mOS)时间和中位无进展生存期(mPFS)时间评价疗效,使用不良事件（AE）的发生率来评估安全性。
■中位随访时间为31.9个月，客观反应率（ORR）为59％，疾病控制率(DCR)为89.8%。MOS时间为20.0个月，6个月OS率为95%。mPFS时间为9.2个月，6个月PFS率为78%。没有治疗相关的死亡。肺炎发生率为23.1%,放射性食管炎的发病率为5.1%,2例患者出现高级别肺炎。原发性肝转移是OS和PFS差的预测因子。在化学免疫疗法后接受巩固性TRT的患者比接受TRT作为上腔静脉综合征或疾病进展的姑息或挽救性治疗的患者受益更多。
■考虑到其相当大的疗效和可耐受的安全风险，TRT对于接受化学免疫疗法治疗ES-SCLC的患者是一种可行的治疗方法。这种治疗对于没有原发性肝转移并且在化学免疫疗法后接受巩固性TRT的患者特别有用。需要大规模的前瞻性研究来证实这种治疗方式的有效性和安全性。
■回顾性分析2019年1月至2023年1月在金陵医院和江苏省肿瘤医院接受TRT联合化学免疫治疗的78例ES-SCLC患者的病历。采用中位总生存期(mOS)时间和中位无进展生存期(mPFS)时间评价疗效,使用不良事件（AE）的发生率来评估安全性。
■中位随访时间为31.9个月，客观反应率（ORR）为59％，疾病控制率(DCR)为89.8%。MOS时间为20.0个月，6个月OS率为95%。mPFS时间为9.2个月，6个月PFS率为78%。没有治疗相关的死亡。肺炎发生率为23.1%,放射性食管炎的发病率为5.1%,2例患者出现高级别肺炎。原发性肝转移是OS和PFS差的预测因子。在化学免疫疗法后接受巩固性TRT的患者比接受TRT作为上腔静脉综合征或疾病进展的姑息或挽救性治疗的患者受益更多。
■考虑到其相当大的疗效和可耐受的安全风险，TRT对于接受化学免疫疗法治疗ES-SCLC的患者是一种可行的治疗方法。这种治疗对于没有原发性肝转移并且在化学免疫疗法后接受巩固性TRT的患者特别有用。需要大规模的前瞻性研究来证实这种治疗方式的有效性和安全性。
