Real‐World Analysis of Treatment Patterns in Limited‐Stage Small Cell Lung Cancer: Implications for Clinical Practice

ABSTRACT Background Unresolved issues complicate treating limited‐stage small‐cell lung cancer (LS‐SCLC). We conducted a real‐world study analyzing LS‐SCLC treatment patterns to address clinical needs. Methods We retrospectively enrolled patients with LS‐SCLC treated at Peking Union Medical College Hospital between May 2008 and December 2023. Information was collected on clinicopathological features, cancer‐related treatments, laboratory test results, and clinical and prognostic data. Kaplan–Meier survival analysis was performed to evaluate progression‐free (PFS) and overall survival (OS). Cox regression models were used to assess the factors influencing survival. Results Among the 203 patients with LS‐SCLC, the median OS (mOS) was 28.8 months. Log‐rank testing revealed significant mOS differences among radiotherapy timing groups ( p = 0.031): concurrent chemoradiotherapy (cCRT) 30.1 months, sequential therapy 27.5 months, and no radiotherapy 21.7 months. Early cCRT showed a non‐significant mOS trend advantage over late cCRT (38.3 vs. 29.5 months, p = 0.058). Prophylactic cranial irradiation (PCI) demonstrated comparable mOS (36.9 vs. 29.6 months, p = 0.27). Peripheral blood biomarkers (PBBs) lacked prognostic significance. Multivariate analysis identified Eastern Cooperative Oncology Group (ECOG) performance status (PS) > 1 (HR = 3.652, 95% CI 1.579–8.448; p = 0.002) and N2/N3 metastasis (N2: HR = 2.872, 95% CI 1.312–6.286, p = 0.008; N3: HR = 2.645, 95% CI 1.195–5.856, p = 0.016) as survival predictors. Sequential radiotherapy increased mortality risk versus early cCRT (HR = 1.701, 95% CI 1.125–2.573; p = 0.012). Conclusions Performance status and lymph node metastasis are prognostic factors for patients with LS‐SCLC. cCRT improves the prognosis of LS‐SCLC, with early cCRT providing a significant survival benefit and late cCRT being an acceptable option.