Association of radiotherapy with survival across metastatic patterns in metastatic small cell lung cancer in the immunotherapy era: a SEER analysis.

Authors

Shulin Zhao, Zhixiang Bo, Ping Chen, Chu Gao, Jin Huang, Cheng Shen

Published in

Japanese journal of clinical oncology. Sep 29, 2026. Epub Sep 29, 2026.

Abstract

Radiotherapy (RT) combined with chemoimmunotherapy may have synergistic effects and improve treatment efficacy and survival in extensive-stage small cell lung cancer (ES-SCLC). However, its association with survival appears to be inconsistent across different metastatic patterns.
Patients with metastatic SCLC diagnosed between 2020 and 2023 were identified from the Surveillance, Epidemiology, and End Results database. Propensity score matching (PSM), Kaplan-Meier analysis, and Cox regression were used to evaluate the association between RT and cancer-specific survival (CSS). Inverse probability of treatment weighting (IPTW) and overlap weighting were performed as sensitivity analyses.
A total of 4707 patients were included. Liver metastasis was the most common site-specific metastasis (44.1%), followed by bone (42.1%), brain (30.1%), and lung metastasis (16.1%). Multi-organ metastases without brain involvement were the most common metastatic pattern (21.2%), followed by other/unspecified (16.0%) and multi-organ metastases with brain involvement (15.5%). After 1:1 PSM, additional RT was associated with higher CSS in the liver only (HR, 0.68; 95% CI, 0.51-0.91; P = .009), lung only (HR, 0.55; 95% CI, 0.38-0.80; P = .002), multi-organ without brain (HR, 0.77; 95% CI, 0.64-0.92; P = .005), and other/unspecified cohorts (HR, 0.67; 95% CI, 0.54-0.82; P < .001). No significant association was observed in the bone only, brain only, or multi-organ with brain cohorts. IPTW and overlap weighting analyses yielded consistent results.
In the immunotherapy era, among patients with metastatic SCLC receiving first-line chemoimmunotherapy, the association between additional RT and CSS may vary across metastatic patterns.

PMID:
42810410
Bibliographic data and abstract were imported from PubMed on 30 Sep 2026.

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