Multicenter Cohort Study of Original or Substitute Systemic Therapy With or Without Brain Radiotherapy for Extensive-Stage Small Cell Lung Cancer With Brain-Only Progression After First-Line Treatment
2 hours ago
- #Brain Radiotherapy
- #Small Cell Lung Cancer
- #Second-Line Therapy
- Study focused on optimal second-line strategy for extensive-stage small cell lung cancer (ES-SCLC) patients with brain-only progression after first-line treatment.
- Compared three strategies: continuation of original systemic therapy plus brain radiotherapy (OTP + BRT), substitution therapy plus BRT (ST + BRT), and substitution therapy alone (ST).
- OTP + BRT showed significantly better median overall survival from second-line initiation (14.7 months) compared to ST (10.2 months) and ST + BRT (9.8 months).
- OTP + BRT also improved median second-line progression-free survival (8.0 months) versus ST (4.0 months).
- Benefit was most notable in patients with prior immunotherapy and longer initial progression-free survival (≥7.5 months). No significant difference between whole-brain radiotherapy and stereotactic radiosurgery.
- Conclusion supports continuing original systemic therapy plus brain radiotherapy as superior for controlling central nervous system progression while maintaining effective systemic treatment.