Role of radiotherapy on long-term outcomes of patients with small cell lung cancer under different metastasis patterns.

IF 2.5 3区医学 Q3 ONCOLOGY

World Journal of Surgical Oncology Pub Date : 2025-04-07 DOI:10.1186/s12957-025-03766-6

Hui Dong, Wei Wang

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引用次数: 0

Abstract

Objective: Assessing the role of radiotherapy on the long-term outcomes in patients with small cell lung cancer (SCLC).

Methods: A total of 6819 patients with SCLC diagnosed histologically from 2011 to 2020 were collected from the Surveillance, Epidemiology, and End Results database. The importance of radiation on overall survival (OS) and cancer-specific survival (CSS) was assessed by a random forest algorithm. The association of radiation with OS and CSS was evaluated by COX regression and subgroup analysis. The survival difference between radiation and non-radiation groups was analyzed by the Kaplan-Meier (KM) method. The conditional survival (CS) and competing risk analyses were performed to evaluate the influence of radiation on CSS.

Results: Among all variables, the importance of tumor metastasis to OS and CSS ranked first. COX regression analysis indicated independent association (all P < 0.05) of radiation with OS and CSS in patients with metastasis in the liver, lymphatic, and other sites (not found in bone and brain). KM showed better OS and CSS in the radiation group (vs. non-radiation) in the 3 types of metastases (all P < 0.05). Among 5 metastasis patterns, liver metastasis (LM) was identified as the key pattern to OS and CSS. We found that LM patients with chemotherapy, female, and stage IV can significantly benefit from radiotherapy. However, radiation cannot decrease the incidence of cancer-specific death in male LM patients.

Conclusions: This study determined the importance of radiotherapy on the long-term outcomes of patients. In particular, male LM patients may not benefit from radiotherapy.

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不同转移模式下放疗对小细胞肺癌患者长期疗效的影响

目的：探讨放疗对小细胞肺癌（SCLC）患者远期预后的影响。方法：从监测、流行病学和最终结果数据库中收集2011年至2020年组织学诊断为SCLC的6819例患者。采用随机森林算法评估放疗对总生存期（OS）和肿瘤特异性生存期（CSS）的重要性。采用COX回归和亚组分析评价放疗与OS和CSS的相关性。采用Kaplan-Meier （KM）法分析放疗组与非放疗组的生存差异。通过条件生存（CS）和竞争风险分析来评估辐射对CS的影响。结果：在所有变量中，肿瘤转移对OS和CSS的重要性居首位。COX回归分析显示独立关联（均为P）。结论：本研究确定了放疗对患者长期预后的重要性。特别是男性LM患者可能无法从放疗中获益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.