Journal Article

Comparison the efficiency of whole brain radiotherapy and simultaneous integrated boost in small cell lung cancer with brain metastases

Bi, Nan, Lv, Jima, Wang, Xin, Wu, Yuqi, Zhou, Zongmei, Shan, Xia, Feng, Qinfu, Xiao, Zefen, Wang, Wenqing, Deng, Lei, Liu, Wenyang, Wang, Jianyang, Zhang, Tao

2025

Overview

Background This study aims to compare the therapeutic efficacy of whole brain radiotherapy (WBRT) versus WBRT plus simultaneous integrated boost (WBRT + SIB) in patients with brain metastases (BMs) from small cell lung cancer (SCLC). Methods A retrospective analysis was conducted on 127 patients with BMs from SCLC who received brain radiotherapy between 2014 and 2023 at the Cancer Hospital of the Chinese Academy of Medical Science. Among them, 71 patients underwent WBRT (25.0–54.0 Gy in 10–21 fractions), while 56 patients received WBRT + SIB (SIB to metastases: 18.0–60.0 Gy in 5–20 fractions). The overall survival (OS), intracranial progression-free survival (iPFS), objective response rate (ORR), and local control rate (LCR) were evaluated to assess the efficacy of the treatments. Results With a median follow-up of 14.9 months, the median OS was significantly longer in the WBRT + SIB group compared to the WBRT group (18.0 vs. 11.7 months). Similarly, the iPFS was extended in the WBRT + SIB group (12.2 vs. 7.6 months). Kaplan-Meier analysis revealed that WBRT + SIB significantly improved OS in patients with SCLC of BMs ( P  = 0.009). Subgroup analysis indicated that male patients, age < 60 years old, and multiple intracranial metastases benefited more from WBRT + SIB. Interaction tests suggested that age significantly influence the efficacy of WBRT + SIB, with patients < 60 years old deriving more benefit ( P  = 0.049). Concurrent WBRT + SIB with anti-angiogenic targeted therapy significantly improved iPFS ( P  < 0.001). Conclusions WBRT + SIB can prolong the OS in SCLC patients with BMs, with younger age and those receiving anti-angiogenesis therapy potentially achieving additional survival benefits.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Aged, 80 and over / Angiogenesis / Biomedical and Life Sciences / Biomedicine / Brain cancer / Brain metastases / Brain Neoplasms - mortality / Brain Neoplasms - radiotherapy / Brain Neoplasms - secondary / Cancer Research / Cancer therapies / Care and treatment / Chemotherapy / Chi-square test / Complications and side effects / Cranial Irradiation - methods / Female / Health Promotion and Disease Prevention / Humans / Kaplan-Meier Estimate / Lung cancer / Lung cancer, Small cell / Lung Neoplasms - mortality / Lung Neoplasms - pathology / Lung Neoplasms - radiotherapy / Magnetic resonance imaging / Male / Medical prognosis / Medicine/Public Health / Metastases / Metastasis / Methods / Middle Aged / Oncology / Patient outcomes / Patients / Radiation therapy / Retrospective Studies / Simultaneous integrated boost (SIB) / Small cell lung cancer (SCLC) / Small cell lung carcinoma / Small Cell Lung Carcinoma - mortality / Small Cell Lung Carcinoma - pathology / Small Cell Lung Carcinoma - radiotherapy / Small Cell Lung Carcinoma - secondary / Surgical Oncology / Survival analysis / Therapeutic efficacy / Tomography / Treatment Outcome / Whole brain radiotherapy / Whole brain radiotherapy (WBRT)