Abstract Background Approximately 60% of patients with small cell lung cancer (SCLC) develop brain metastases(BM). Historically these have been managed with whole brain radiotherapy. FIRE-SCLC study provides a benchmark for survival with SRS, demonstrating a median overall survival(mOS) of 8.5 months(m). Methods We conducted a retrospective analysis of a prospectively collected dataset of patients with SCLC receiving stereotactic radiosurgery (SRS) for BM at our centre from 05/2016-10/2024. The primary objective was mOS. Survival analysis was calculated from time of first SRS to death, performed on Prism 10.1.1,. Extraction from electronic medical records was undertaken by authors, with local R&D approval. Results 40 patients were evaluable. 20% of patients (N = 8/40) received multiple treatments. Median follow up time was 8.7 m. Median OS was 10.0 m. mOS of patients with 1 lesion was 13.8 m, vs 8.4 and 8.7 m for 2-4 and 5-10 BM. mOS for patients with KPS ≥ 90 12.4 m vs 8.7 m for those with KPS ≤ 80 (HR 1.63, P = 0.15). There was one death within 28 days of SRS. 5 patients died within 90 days of SRS. Conclusion Median OS in this cohort of patients with SCLC BM compared favourably to the FIRE-SCLC cohort, supporting consideration in selected patients. Our cohort was limited by sample size. Further prospective research is needed to guide local therapies in ES-SCLC BM, particularly regarding adverse events. Advances in knowledge UK real-world data demonstrate survival outcomes with SRS for SCLC BM was comparable to FIRE-SCLC, supporting feasibility under NHS commissioning criteria.
McMahon et al. (Wed,) studied this question.
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