Efficacy and safety of immunotherapy combined with chemoradiotherapy in limited-stage small cell lung cancer: a systematic evaluation and meta-analysis of randomized controlled trials.

BACKGROUND: Concurrent chemoradiotherapy (cCRT) remains the standard treatment for patients diagnosed with limited-stage small-cell lung cancer (LS-SCLC); however, recurrence rates remain high and prognosis remains poor. This study collected data regarding patient-reported outcomes and adverse events (AEs) to evaluate the effects of chemoradiotherapy combined with immunotherapy in patients with LS-SCLC. METHODS: A systematic literature search of 7 electronic databases was conducted for randomized, placebo-controlled trials enrolling patients diagnosed with LS-SCLC who received chemoradiotherapy combined with immunotherapy. Trials with unstratified LS-SCLC samples were excluded. A subsequent meta-analysis was performed. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under accession number CRD42024607159. RESULTS: Nine trials comprising 1,853 patients were included. CCRT combined with immunotherapy exhibited a significant favorable trend in survival outcomes, with hazard ratios (HRs) for median progression-free survival (mPFS) and median overall survival (mOS) of 0.838 (95% confidence interval [CI]: 0.742-0.947) and 0.847 (95% CI: 0.736-0.975), especially in the consolidation group with HRs for mPFS and mOS of 0.793 (95% CI: 0.675-0.930) and 0.757 (95% CI: 0.551-1.040), respectively. CONCLUSION: CCRT combined with immunotherapy improved survival in patients with LS-SCLC, especially in the consolidation immunotherapy group. The treatment regimen was generally well tolerated, with an acceptable incidence of treatment-related adverse events (TRAEs). SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD42024607159.