Abstract
BackgroundThe treatment for brain metastases in small cell lung cancer (SCLC) is still controversial. The purpose of this study was to compare different brain radiotherapy treatments on SCLC patients with brain metastases.MethodsIn this multi-center retrospective study, SCLC patients who had undergone whole brain radiation therapy (WBRT) or stereotactic radiosurgery (SRS) for brain metastases from January 2012 to December 2018 were retrospectively screened.ResultsA total of 263 eligible SCLC patients were included in this study, among whom, 73 were women and 190 were men. According to accepted brain radiotherapy, the remaining patients were divided into WBRT plus focal radiation boost (WBRT+boost), WBRT, and SRS groups. In pairwise comparisons of the overall survival (OS), WBRT+boost group led to longer survival than did WBRT both in all patients (17.9 vs 8.7 months; P < 0.001) and 140 matched patients (17.9 vs 11.7 months; P = 0.045). There were no significant differences in OS between WBRT+boost and SRS groups in all patients (17.9 vs 14.5 months; P = 0.432). Among 74 matched patients between WBRT+boost and SRS groups, however, patients who received WBRT+boost led to a longer survival than did SRS alone (21.8 vs 12.9 months; P = 0.040). In pairwise comparison of the intracranial progression-free survival time (iPFS), WBRT+boost group also showed survival advantages over WBRT (10.8 vs 6.5 months; P = 0.005) and SRS groups (10.8 vs 7.5 months; P = 0.032).ConclusionDue to the SCLC-derived multiple brain metastases and better survival time, focal radiation boost combined with adjuvant WBRT may be a preferred strategy for SCLC patients with brain metastases.
Highlights
Brain metastases are the most common central nervous system tumors, and the most common primary site is lung cancer [1]
small cell lung cancer (SCLC) patients who had undergone whole brain radiotherapy (WBRT) or stereotactic radiosurgery (SRS) for brain metastases were retrospectively retrieved from January 2012 to December 2018
Due to the properties of multiple metastases, WBRT was considered the standard treatment for brain metastases from SCLC patients
Summary
Brain metastases are the most common central nervous system tumors, and the most common primary site is lung cancer [1]. The most common pathological type of brain metastases is small cell lung cancer (SCLC) [2, 3]. According to the NCCN Guidelines for Small Cell Lung Cancer Version 2.2020, whole brain radiotherapy (WBRT) is recommended as a standard treatment for brain metastases in patients with SCLC [10]. Randomized controlled trial is conducted to investigate the efficacy of SRS alone in SCLC patients with 1–10 brain metastases [13]. The purpose is to compare three different radiotherapy methods currently used clinically for brain metastases in SCLC patients in this study. The treatment for brain metastases in small cell lung cancer (SCLC) is still controversial. The purpose of this study was to compare different brain radiotherapy treatments on SCLC patients with brain metastases
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