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ARTICLE

A Retrospective Real-World Study: The Efficacy and Safety of Immune Checkpoint Inhibitors Combined with Chemoradiotherapy in Limited-Stage Small Cell Lung Cancer

Ruoxue Cai1,#, Shuyi Hu2,#, Feiyang Li2, Huanhuan Sha3,*, Guoren Zhou2,*, Ying Fang3
1 Department of Oncology, Geriatric Hospital of Nanjing Medical University, Jiangsu Province Official Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
2 Department of Oncology, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, 210009, China
3 Department of Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
* Corresponding Author: Huanhuan Sha. Email: email; Guoren Zhou. Email: email
# These authors contributed equally to this work and shared first authorship.
(This article belongs to the Special Issue: Advances in Cancer Therapeutics)

Oncology Research https://doi.org/10.32604/or.2025.070893

Received 26 July 2025; Accepted 29 September 2025; Published online 30 October 2025

Abstract

Objective: To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer (LS-SCLC). We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients. Methods: We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy (CCRT) or sequential chemoradiotherapy (SCRT) (Group A) and immunotherapy combined with CCRT/SCRT followed by immunotherapy (Group B), to assess the objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS). Factors affecting prognosis were also explored using Cox analysis. The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens. Results: The overall ORR was 55.93%. The overall DCR was 98.31%. The DCR was 100% in Group A and 96.61% in Group B. There was no statistical difference in ORR and DCR. The overall median PFS was 9.86 months (95% CI, 8.62–11.10), and the difference in median PFS between the two groups was statistically significant (8.94 vs. 11.89 months, p = 0.03). The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis. Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT. Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I + II + IIIA. Conclusion: We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT. Type 2 diabetes and TNM stage affect the survival prognosis. Patients with type 2 diabetes may benefit from immunotherapy combination treatments.

Keywords

Limited-stage small cell lung cancer; immunotherapy; chemoradiotherapy; TNM stage; type 2 diabetes

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