Impact of thoracic radiation therapy after chemotherapy on survival in extensive‐stage small cell lung cancer: A propensity score‐matched analysis

Abstract

Background The role of thoracic radiation therapy (TRT) after chemotherapy (CHT) in extensive‐stage small cell lung cancer (ES‐SCLC) has not been well defined. We investigated whether intensity‐modulated radiotherapy (IMRT) improves outcomes in ES‐SCLC after CHT compared to CHT alone. Methods A total of 292 patients who reached a complete response (CR), partial response (PR), or stable disease (SD) after CHT were assigned into groups: CHT + TRT and CHT alone. Propensity score matching was used to balance patient groups (n = 72 each). Results The five‐year overall survival (OS: 12.3% vs. 3.6%; P 6 cycles of CHT (P = 0.042), CR + PR after CHT (P < 0.001), and TRT (P < 0.001) were independently associated with longer OS compared to CHT alone. Conclusion TRT using IMRT is strongly correlated with improved OS and PFS in ES‐SCLC patients reaching CR, PR or SD after CHT. A multicenter, randomized phase III clinical trial is needed to confirm these findings.

Keywords

• Carcinoma, small cell
• chemotherapy
• intensity‐modulated
• lung neoplasm
• radiotherapy