中国肺癌杂志2024，Vol.27Issue(11)：831-839,9.DOI:10.3779/j.issn.1009-3419.2024.102.41
放疗联合免疫治疗和化疗改善广泛期小细胞肺癌预后并展现协同作用
Radiotherapy Combined with Immunotherapy and Chemotherapy Improves Prognosis and Demonstrates Synergistic Effects in Extensive-stage Small Cell Lung Cancer
摘要
Abstract
Background and objective Extensive-stage small cell lung cancer(ES-SCLC)is a malignant tumor with remarkable proliferative and invasive ability,which has very poor clinical prognosis due to lack of effective treatments.This study aims to evaluate the efficacy and synergistic effects of radiotherapy(RT)combined with immunotherapy(IT)and chemotherapy(CT)in patients with ES-SCLC.Methods A retrospective analysis was performed on 145 ES-SCLC patients treated with first-line CT.Kaplan-Meier analysis and Log-rank tests were used to evaluate survival outcomes,while propensity score matching(PSM)was applied to reduce confounding factors.Results The median overall survival(mOS)and median progression-free survival(mPFS)for the entire cohort were 15.7 and 6.9 mon,respectively.The IT+CT group had a signifi-cantly longer mOS compared to the CT group(17.2 vs 13.5 mon,P=0.047).Similarly,the RT+CT group demonstrated supe-rior mOS(18.5 vs 12.3 mon,P＜0.001)and mPFS(7.1 vs 6.2 mon,P=0.006)compared to the CT group.Multivariate analysis identified RT,IT,and Eastern Cooperative Oncology Group performance status(ECOG PS)as independent prognostic factors for mOS(P＜0.05),while gender and ECOG PS were independent predictors for mPFS(P＜0.05).Following PSM,the RT+CT group continued to exhibit significant advantages in mOS(18.0 vs 12.1 mon,P＜0.001)and mPFS(7.1 vs 5.5 mon,P=0.037)compared to the CT group.Notably,the RT+IT+CT group achieved a markedly longer mOS than the IT+CT group(28.5 vs 15.8 mon,P=0.017).Grade 3-4 adverse events occurred in 27.6％of patients,with no grade 5 adverse events reported.Conclu-sion The combination of RT,IT,and CT significantly enhances the prognosis of ES-SCLC patients.RT plays a key role in their synergistic effects and demonstrates good safety,warranting further research and clinical application.关键词
肺肿瘤/免疫治疗/放疗/协同效应Key words
Lung neoplasms/Immunotherapy/Radiotherapy/Synergistic effect引用本文复制引用
季怀君,孙美玲,李静宜,于戈,陈勇兵..放疗联合免疫治疗和化疗改善广泛期小细胞肺癌预后并展现协同作用[J].中国肺癌杂志,2024,27(11):831-839,9.基金项目
本研究受国家自然科学基金面上项目(No.82172076、No.82472140),江苏省卫健委重点科研项目(No.ZD2021033),苏州大学临床创新交叉转化项目(No.ML12301623)与苏州大学临床医学科技高端平台和转化基地建设项目(No.ML12301123)资助 This study was supported by the grants from National Natural Science Foundation of China(No.82172076,No.82472140),Key Scientific Program of Jiangsu Provincial Health Commission(No.ZD2021033),Clinical Innovation and Interdisciplinary Translation of Soochow University(No.ML12301623)and Construction Project of High-end Clinical Medi-cal Technology Platform and Translational Base of Soochow University(No.ML12301123)(All to Yongbing CHEN). （No.82172076、No.82472140）
