2517 - Hypofractionated Radiotherapy Sequenced with Immuno-Chemotherapy for Limited-Stage Small-Cell Lung Cancer
Presenter(s)
K. Xu1, X. Guo2, and W. Jiang3; 1National Cancer & Clinical Research Center/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China, 2Department of Medical Records, National Cancer Center / National Cancer Clinical Research Center / Cancer Hospital / Shenzhen Hospital, Chinese Academy of Medical Sciences, Shenzhen 518116, China., Shenzhen, China, 3Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China, Shenzhen, China
Purpose/Objective(s): The current standard treatment for limited-stage small-cell lung cancer (LS-SCLC) involves chemotherapy combined with concurrent chemoradiotherapy and prophylactic cranial irradiation (PCI). Our study aimed to demonstrate the efficacy and safety of induction immunochemotherapy followed by hypo-fractionated radiotherapy (Hypo-RT) for LS-SCLC.
Materials/Methods: Medical records of LS-SCLC patients from August 2020 to August 2024 were collected. All patients treated with chemoimmunotherapy followed by hypo-fractionated radiotherapy (HypoRT) were eligible for analysis. HypoRT, consisting of 45 Gy administered in 15 once-daily fractions, was given after immune checkpoint inhibitors (ICIs,=1 cycles) in combination with etoposide or carboplatin and platinum (EP or EC), provided there was no progression. Prophylactic cranial irradiation (PCI) was recommended.
Results: Of the 24 participants, 20 were included in the study. The median age was 63 years (range, 34-75), with 18 male patients (81.8%). Stage IIIb was present in 14 patients (70.0%), IIIa in 3 (15.0%), and IIb in 2 (10.0%). All patients had an Eastern Cooperative Oncology Group performance status (PS) of 0 or 1 and received an intensity-modulated radiotherapy plan,and 50% patients received PCI. With a median follow-up duration of 23.1 months (95% confidence interval: 21.1-25.0), the median progression-free survival (PFS) was 26.4 months (CI not reached), and overall survival (OS) data were not yet mature. Six patients (30%) developed Grade 2 radiation pneumonitis, and 1 patient (10%) experienced immune-related pneumonitis. Six patients discontinued ICIs treatment due to toxicity (4 with Grade 2 pneumonitis, 1 with abnormal elevation of amylase, and 1 with fever).
Conclusion: Our real-world data indicates that Hypofractionated radiotherapy sequenced with immuno-chemotherapy demonstrates promising clinical efficacy and tolerable safety in cases of LS-SCLC