To explore the most suitable dosage regimen for limited-stage small cell lung cancer (LS-SCLC) and provide references for clinical selection, strict inclusion criteria were applied, and studies were screened from Pubmed, Embase, and Web of Science. Subsequently, data on two-year overall survival rates and dosage regimens were collected, and scatter plots were constructed to provide a comprehensive perspective. The survival benefits of various dosage regimens were evaluated, and a linear quadratic equation was utilized to fit the relationship between the biologically effective dose (BED10) and the two-year overall survival rate. Among the five randomized controlled trials, the two-year overall survival rate of ConvTRT regimens with BED10 > 60 Gy (rough value) was only at or below the median of all ConvTRT regimens or all included study regimens, indicating that increasing the number and total dose of ConvTRT does not necessarily lead to better prognosis. In the exploration of HypoTRT regimens, there was a linear positive correlation between BED10 and the two-year overall survival rate (p< 0.0001), while the exploration of HyperTRT regimens was relatively limited, with the majority focused on the 45 Gy/30 F regimen. However, the current 45 Gy/30 F regimen is not sufficient to control LS-SCLC, resulting in a high local recurrence rate. High-dose ConvTRT regimens have long treatment durations and may induce tumor regrowth which may cause reduced efficacy. Under reasonable toxicity reactions, HyperTRT or HypoTRT with higher radiotherapy doses is recommended for treating LS-SCLC.
为探索局限期小细胞肺癌（LS-SCLC）最适放疗方案并为临床选择提供参考，本研究采用严格的纳入标准，从Pubmed、Embase和Web of Science数据库筛选相关研究。随后收集两年总生存率与放疗方案数据，构建散点图以提供全面视角。通过评估不同放疗方案的生存获益，并运用线性二次方程拟合生物有效剂量（BED10）与两年总生存率的关系。在五项随机对照试验中，BED10＞60 Gy（约值）的常规分割放疗方案两年总生存率仅处于或低于所有常规分割方案或所有纳入研究方案的中位水平，表明增加常规分割放疗次数与总剂量未必能改善预后。在探索大分割放疗方案时，发现BED10与两年总生存率呈线性正相关（p<0.0001），而超分割放疗方案的探索相对有限，主要集中在45 Gy/30次方案。然而现有45 Gy/30次方案尚不足以控制LS-SCLC，导致局部复发率较高。高剂量常规分割放疗方案治疗周期长，可能诱发肿瘤再增殖从而导致疗效降低。在可耐受的毒性反应前提下，建议采用更高放疗剂量的超分割或大分割方案治疗LS-SCLC。
The Dose/Fractionation Debate in Limited-Stage Small Cell Lung Cancer
肿瘤(癌症)患者之家