Benefits and risks of prophylactic glucocorticoids in platinum chemotherapy for extensive-stage small-cell lung cancer: A retrospective study.

Abstract

The objective of the present study was to analyze the effects of prophylactic glucocorticoid use on the efficacy and adverse reactions of platinum-based intravenous regimens in patients with extensive-stage small-cell lung cancer (ES-SCLC). The present study retrospectively analyzed 103 newly diagnosed patients with ES-SCLC treated with etoposide plus platinum at the First Affiliated Hospital of Anhui Medical University from August 2022 to December 2024. Patients were divided into glucocorticoid (63 cases) and control (40 cases) groups. Baseline characteristics, adverse reaction rates and treatment outcomes were compared between groups. The hormone group showed no significant differences in objective response rate (ORR) and disease control rate (DCR) but had lower incidences of nausea/vomiting (P=0.005), constipation (P=0.002) and leukopenia (P=0.009). In patients also receiving immune checkpoint inhibitors (ICIs), the hormone group had improved renal function protection (P=0.026). Although hypertension incidence was higher in the hormone group, the difference was not statistically significant (P>0.05). Hyperglycemia rates and median survival time were similar between groups. In conclusion, prophylactic glucocorticoids do not significantly affect ORR, DCR, or median survival in patients with ES-SCLC on etoposide plus platinum with or without ICIs but can reduce nausea/vomiting, constipation and leukopenia. They may protect kidney function when combined with ICIs. No major adverse events were linked to glucocorticoid use, so their prophylactic use is recommended in platinum-based ES-SCLC therapy.