本研究的目的是评估广泛期小细胞肺癌 (ES-SCLC) 患者接受 durvalumab 一线治疗后后续放疗 (RT) 的安全性和有效性。 共有 122 名 ES 患者-对3家医院2019年7月至2021年12月期间的SCLC进行回顾性分析。进行治疗加权逆概率（IPTW）分析来解决潜在的混杂因素。我们评估的主要重点是评估 RT 对无进展生存期 (PFS) 和总生存期 (OS) 的影响。IPTW 分析后，49 名患者接受了 durvalumab 加铂依托泊苷 (EP) 化疗，然后接受 RT (Durva EP) RT）和 72 名患者接受了免疫化疗（Durva EP）。中位 OS 为 17.2 个月 vs. 12.3 个月（风险比 [HR]：0.38，95% CI：0.17-0.85，P = 0.020），中位 PFS 为 8.9 个月 vs. 5.9 个月（HR：0.56，95%） Durva EP RT 组和 Durva EP 组的 CI：0.32-0.97，P = 0.030。与针对其他转移部位的放疗相比，胸部放疗 (TRT) 的 OS（17.2 个月 vs. 14.7 个月）和 PFS（9.1 个月 vs. 7.2 个月）更长。在寡转移患者中，放疗也显示出显着的益处，与不放疗相比，中位 OS 为 17.4 个月 vs. 13.7 个月，中位 PFS 为 9.8 个月 vs. 5.9 个月。与无 TBP 的患者相比，在 Durva EP RT（NA 与 15.8 个月，HR：0.48，95% CI：0.14-1.63，P = 0.238）和 Durva EP 组中，持续性 durvalumab 治疗超过进展（TBP）可延长 OS（ 12.3 个月与 4.3 个月，HR：0.29，95% CI：0.10-0.81，P = 0.018）。两组中分别有 13 名（26.5%）和 13 名（18.1%）患者发生 3 级或 4 级不良事件；肺炎大多是低级别的。一线免疫化疗后添加 RT 显着改善了 ES-SCLC 的生存结果，且毒性可控。版权所有 © 2024 中华医学会，由 Wolters Kluwer, Inc. 制作，CC-BY-NC- ND 许可证。

The purpose of this study was to evaluate the safety and efficacy of subsequent radiotherapy (RT) following first-line treatment with durvalumab plus chemotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC).A total of 122 patients with ES-SCLC from three hospitals during July 2019 to December 2021 were retrospectively analyzed. Inverse probability of treatment weighting (IPTW) analysis was performed to address potential confounding factors. The primary focus of our evaluation was to assess the impact of RT on progression-free survival (PFS) and overall survival (OS).After IPTW analysis, 49 patients received durvalumab plus platinum-etoposide(EP) chemotherapy followed by RT (Durva + EP + RT) and 72 patients received immunochemotherapy (Durva + EP). The median OS was 17.2 months vs. 12.3 months (hazard ratio [HR]: 0.38, 95% CI: 0.17-0.85, P = 0.020), and the median PFS was 8.9 months vs. 5.9 months (HR: 0.56, 95% CI: 0.32-0.97, P = 0.030) in Durva + EP + RT and Durva + EP groups, respectively. Thoracic radiation therapy (TRT) resulted in longer OS (17.2 months vs. 14.7 months) and PFS (9.1 months vs. 7.2 months) compared to RT directed to other metastatic sites. Among patients with oligo-metastasis, RT also showed significant benefits, with a median OS of 17.4 months vs. 13.7 months and median PFS of 9.8 months vs. 5.9 months compared to no RT. Continuous durvalumab treatment beyond progression (TBP) prolonged OS compared to patients without TBP, in both the Durva + EP + RT (NA vs. 15.8 months, HR: 0.48, 95% CI: 0.14-1.63, P = 0.238) and Durva + EP groups (12.3 months vs. 4.3 months, HR: 0.29, 95% CI: 0.10-0.81, P = 0.018). Grade 3 or 4 adverse events occurred in 13 (26.5%) and 13 (18.1%) patients, respectively, in the two groups; pneumonitis was mostly low-grade.Addition of RT after first-line immunochemotherapy significantly improved survival outcomes with manageable toxicity in ES-SCLC.Copyright © 2024 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.