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National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era
Journal article   Open access   Peer reviewed

National Trends in Radiation Treatment for Small Cell Lung Cancer Brain Metastases in the Modern Era

Jay Desai, Sujay Rajkumar, Matthew J. Shepard and Rodney E. Wegner
Advances in radiation oncology, v 10(3), pp 101720-101720
01 Mar 2025
DOI: https://doi.org/10.1016/j.adro.2025.101720
PMID: 40041762
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1016/j.adro.2025.101720View
Published, Version of Record (VoR) Open

Abstract

Purpose: Small cell lung cancer (SCLC) is a highly aggressive form of lung cancer that often leads to brain metastases. Traditional treatment has largely relied on whole brain radiation therapy (WBRT). However, concerns about neurocognitive side effects have led to the adoption of advanced techniques such as hippocampal avoidance WBRT (HA-WBRT) and stereotactic radiosurgery (SRS). Methods and Materials: This retrospective study used data from the National Cancer Database spanning from 2010 to 2021. The study included adult patients diagnosed with brain metastases from SCLC who received primary radiation therapy directed at the brain. Patients were categorized into 3 treatment groups: WBRT, HA-WBRT, and SRS. Statistical analyses, including logistic regression, Kaplan–Meier survival analysis, and Cox regression, were performed to identify predictors of treatment type and survival outcomes. Results: The study analyzed 24,858 patients with a median age of 65 years. Over time, there was a significant increase in the use of advanced radiation techniques (HA-WBRT and SRS). SRS and HA-WBRT were associated with longer median survival (10.6 and 10.1 months, respectively) than WBRT (7.3 months). Factors such as advanced age, extracranial disease, and higher comorbidity scores were linked to poorer survival, whereas the use of chemotherapy, immunotherapy, and higher socioeconomic status were associated with improved outcomes. Conclusions: From 2010 to 2021, there has been an increase in the use of more advanced techniques to treat brain metastasis from SCLC. These advanced techniques were associated with improved survival outcomes, although selection bias and the retrospective nature of the study limit definitive conclusions.

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Collaboration types
Domestic collaboration
Web of Science research areas
Oncology
Radiology, Nuclear Medicine & Medical Imaging
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