Longer overall survival (OS) was associated with consolidation chest radiation (CXRT) among patients with extensive-stage small cell lung cancer (ES-SCLC), including patients with ipsilateral pleural effusion (IPE), according to the results of a retrospective study published in Medical Oncology.

“Previous randomized trials suggested CXRT has a modest survival benefit; however, its role in subgroups of ES-SCLC, especially IPE, is unknown,” the authors stated.

The retrospective study analyzed data from 36,762 patients diagnosed with ES-SCLC from 2004 to 2017 from the National Cancer Database (NCDB). The results were independently validated using data from the Surveillance, Epidemiology, and End Results (SEER) program. IPE-positive cases were isolated within stage M1a and compared with other stages to determine CXRT benefit.

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Patients who were of younger age, female sex, had clinical T stage, or treated at a nonacademic institution were more likely to have received CXRT.

In a multivariate analysis, CXRT was associated with prolonged OS in all groups. The median OS among patients with M1a disease was 13.4 months with CXRT compared with 9.3 months without CXRT (hazard ratio [HR], 0.62; 95% CI, 0.58-0.65; P <.0001). Patients with M1b disease also experienced a survival benefit with CXRT, with a median OS of 10.8 months compared with 8.8 months without CXRT (HR, 0.72; 95% CI, 0.70-0.74; P <.0001).

A similar benefit was evident after propensity score matching.

The authors concluded that “…our retrospective NCDB analysis suggests benefit of CXRT in ES-SCLC is more prominent in IPE group…further validation studies are warranted”

Disclosures: One study author declared an affiliation with the pharmaceutical industry. Please see the original reference for author’s full disclosure.


Komiya T, Powell E, Takamori S. Role of thoracic radiation in extensive stage small cell lung cancer: a NCDB analysis. Med Oncol. Published online March 20, 2021. doi:10.1007/s12032-021-01489-8