Chemoimmunotherapy combined with consolidative thoracic radiotherapy for extensive-stage small cell lung cancer: A systematic review and meta-analysis

Introduction This study aimed to evaluate the efficacy and safety of chemoimmunotherapy combined with consolidative thoracic radiation therapy (cTRT) in patients with extensive-stage small cell lung cancer (ES-SCLC). Methods A meta-analysis was conducted. PubMed, Embase, Web of Science, and the Cochrane Library were searched. The study was registered in PROSPERO (registration no. CRD42023410344). Results A total of 4677 studies were initially screened and 15 studies encompassing a total of 1033 patients were included. Chemoimmunotherapy combined with cTRT significantly improved survival (HR = 0.52, 95 % CI: 0.39, 0.68) with favorable 6-month (0.89, 95 % CI: 0.77, 1.00) and 1-year (0.77, 95 % CI: 0.72, 0.82) OS, without affecting ≥3 grade TRAEs (RR = 1.29, 95 % CI: 0.85, 1.98). Pooled 6-month and 1-year PFS were 0.67 (95 % CI: 0.47, 0.86) and 0.38 (95 % CI: 0.22, 0.55), respectively. Incidence of ≥3 grade TRAEs was 0.24 (95 % CI: 0.08, 0.39) and radiation pneumonitis was 0.03 (95 % CI: 0.01, 0.06). Conclusions Chemoimmunotherapy combined with cTRT improves survival and shows favorable outcomes in ES-SCLC patients, with manageable adverse events. Further research with larger samples is needed to confirm these findings.