Wu Daixi, Xu Yangbo, Wang Chao, Xu Tao, Gu Yuqi, Zhang Xiaojia, Wang Aolin, Cui Huijuan
China-Japan Friendship Clinical Medical College, Beijing University of Chinese Medicine, Beijing 100029, P.R. China.
Department of Oncology, Ningbo Municipal Hospital of Traditional Chinese Medicine, Affiliated Hospital of Zhejiang Chinese Medical University, Ningbo, Zhejiang 315000, P.R. China.
Oncol Lett. 2025 May 27;30(1):367. doi: 10.3892/ol.2025.15113. eCollection 2025 Jul.
Small cell lung cancer (SCLC) accounts for 13-17% of lung cancer cases and is characterized by poor differentiation, high malignancy and a propensity for recurrence and metastasis. Limited-stage SCLC (LS-SCLC) typically has a better prognosis than extensive-stage SCLC due to its localized nature. However, even with standard concurrent chemoradiotherapy, the median overall survival (OS) for LS-SCLC is only 30 months, with a 5-year survival rate of merely 29-34%. The present study reported the case a patient with LS-SCLC who received oral temozolomide (TMZ) maintenance therapy, achieving an impressive 6-year survival without disease progression or significant side effects. Factors contributing to this outcome include the cytotoxic effects of TMZ and its potential preventive and therapeutic roles in managing brain metastases. In addition, durvalumab has been proven to prolong OS as maintenance therapy after first-line chemoradiotherapy in patients with LS-SCLC. In the future, maintenance therapy for SCLC should explore combination drug strategies, as integrating TMZ or poly(ADP-ribose) polymerase inhibitors with immunotherapy may enhance patient survival.
小细胞肺癌（SCLC）占肺癌病例的13 - 17%，其特点是分化差、恶性程度高，且易于复发和转移。局限期小细胞肺癌（LS - SCLC）由于其局限性，通常预后比广泛期小细胞肺癌更好。然而，即使采用标准的同步放化疗，LS - SCLC的中位总生存期（OS）也仅为30个月，5年生存率仅为29 - 34%。本研究报告了一例接受口服替莫唑胺（TMZ）维持治疗的LS - SCLC患者，实现了令人瞩目的6年无疾病进展生存且无明显副作用。促成这一结果的因素包括TMZ的细胞毒性作用及其在管理脑转移中的潜在预防和治疗作用。此外，度伐利尤单抗已被证明可作为LS - SCLC患者一线放化疗后的维持治疗延长OS。未来，SCLC的维持治疗应探索联合用药策略，因为将TMZ或聚（ADP - 核糖）聚合酶抑制剂与免疫疗法相结合可能提高患者生存率。
