The British journal of radiology · 2026
Stereotactic radiosurgery (SRS) for small cell lung cancer (SCLC) brain metastases: a real-world UK tertiary center experience.
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McMahon David John, John Alexius, Ketpueak Thanika, De Boisanger James, Sachdeva Aishani, Brewer Martin, Aykac Safa, Yu Tamara, Nangendo Christine, Kalofonou Foteini, Milner-Watts Charlotte, Yousaf Nadia, Davidson Michael, Bhosle Jaishree, Minchom Anna, O'Brien Mary, Popat Sanjay, Welsh Liam, Creak Antonia, Solda Francesca, Taylor Helen, Konadu Jessica, Tokaca Nadza, Rosenfelder Nicola
Аннотация
OBJECTIVES: Approximately 60% of patients with small cell lung cancer (SCLC) develop brain metastases (BM). Historically these have been managed with whole brain radiotherapy. We sought to compare outcomes with the FIRE-SCLC study which provided a benchmark median overall survival 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 center from May 2016 to October 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: Forty patients were evaluable and 20% of patients (N = 8/40) received multiple treatments. The median follow-up time was 8.7 m. The median OS was 10.0 m. mOS of patients with 1 lesion was 13.8 m, vs. 8.4 m and 8.7 m for 2-4 and 5-10 BM. mOS for patients with KPS ≥ 90 was 12.4 m vs. 8.7 m for those with KPS ≤ 80 (HR 1.63, P = .15). There was one death within 28 days of SRS. Five patients died within 90 days of SRS.
CONCLUSION: Median OS in this cohort of patients with SCLC BM compared favorably 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 demonstrates survival outcomes with SRS for SCLC BM comparable to FIRE-SCLC, supporting feasibility under NHS commissioning criteria.
METHODS: We conducted a retrospective analysis of a prospectively collected dataset of patients with SCLC receiving stereotactic radiosurgery (SRS) for BM at our center from May 2016 to October 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: Forty patients were evaluable and 20% of patients (N = 8/40) received multiple treatments. The median follow-up time was 8.7 m. The median OS was 10.0 m. mOS of patients with 1 lesion was 13.8 m, vs. 8.4 m and 8.7 m for 2-4 and 5-10 BM. mOS for patients with KPS ≥ 90 was 12.4 m vs. 8.7 m for those with KPS ≤ 80 (HR 1.63, P = .15). There was one death within 28 days of SRS. Five patients died within 90 days of SRS.
CONCLUSION: Median OS in this cohort of patients with SCLC BM compared favorably 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 demonstrates survival outcomes with SRS for SCLC BM comparable to FIRE-SCLC, supporting feasibility under NHS commissioning criteria.