National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era

IF 2.2 Q3 ONCOLOGY

Advances in Radiation Oncology Pub Date : 2025-01-14 DOI:10.1016/j.adro.2025.101720

Jay Desai BA , Sujay Rajkumar BS , Matthew J. Shepard MD , Rodney E. Wegner MD

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引用次数: 0

Abstract

Purpose

Small cell lung cancer (SCLC) is a highly aggressive form of lung cancer that often leads to brain metastases. Traditional treatment has largely relied on whole brain radiation therapy (WBRT). However, concerns about neurocognitive side effects have led to the adoption of advanced techniques such as hippocampal avoidance WBRT (HA-WBRT) and stereotactic radiosurgery (SRS).

Methods and Materials

This retrospective study used data from the National Cancer Database spanning from 2010 to 2021. The study included adult patients diagnosed with brain metastases from SCLC who received primary radiation therapy directed at the brain. Patients were categorized into 3 treatment groups: WBRT, HA-WBRT, and SRS. Statistical analyses, including logistic regression, Kaplan–Meier survival analysis, and Cox regression, were performed to identify predictors of treatment type and survival outcomes.

Results

The study analyzed 24,858 patients with a median age of 65 years. Over time, there was a significant increase in the use of advanced radiation techniques (HA-WBRT and SRS). SRS and HA-WBRT were associated with longer median survival (10.6 and 10.1 months, respectively) than WBRT (7.3 months). Factors such as advanced age, extracranial disease, and higher comorbidity scores were linked to poorer survival, whereas the use of chemotherapy, immunotherapy, and higher socioeconomic status were associated with improved outcomes.

Conclusions

From 2010 to 2021, there has been an increase in the use of more advanced techniques to treat brain metastasis from SCLC. These advanced techniques were associated with improved survival outcomes, although selection bias and the retrospective nature of the study limit definitive conclusions.

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来源期刊

Advances in Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

4.60

自引率

4.30%

发文量

208

审稿时长

98 days

期刊介绍： The purpose of Advances is to provide information for clinicians who use radiation therapy by publishing: Clinical trial reports and reanalyses. Basic science original reports. Manuscripts examining health services research, comparative and cost effectiveness research, and systematic reviews. Case reports documenting unusual problems and solutions. High quality multi and single institutional series, as well as other novel retrospective hypothesis generating series. Timely critical reviews on important topics in radiation oncology, such as side effects. Articles reporting the natural history of disease and patterns of failure, particularly as they relate to treatment volume delineation. Articles on safety and quality in radiation therapy. Essays on clinical experience. Articles on practice transformation in radiation oncology, in particular: Aspects of health policy that may impact the future practice of radiation oncology. How information technology, such as data analytics and systems innovations, will change radiation oncology practice. Articles on imaging as they relate to radiation therapy treatment.