OBJECTIVES We conducted a systematic review and meta-analysis of survival following treatment recommended by the European Society of Medical Oncology for SCLC in order to determine a benchmark for novel therapies to be compared with. MATERIALS AND METHODS Randomized controlled trials and observational studies reporting overall survival following chemotherapy for SCLC were included. We calculated survival at 30 and 90-days along with 1-year, 2-year and median. RESULTS We identified 160 for inclusion. There were minimal 30-day deaths. Survival was 99 % (95 %CI 98.0-99.0 %, I233.9 %, n = 77) and 90 % (95 %CI 89.0-92.0 %, I279.5 %, n = 73) at 90 days for limited (LD-SCLC) and extensive stage (ED-SCLC) respectively. The median survival for LD-SCLC was 18.1 months (95 %CI 17.0-19.1 %, I277.3 %, n = 110) and early thoracic radiotherapy (thoracic radiotherapy 18.4 months (95 %CI 17.3-19.5, I278.4 %, n = 100)) vs no radiotherapy 11.7 months (95 %CI 9.1-14.3, n = 10), prophylactic cranial irradiation (PCI 19.7 months vs No PCI 13.0 months (95 %CI 18.5-21.0, I275.7 %, n = 78 and 95 %CI 10.5-16.6, I281.1 %, n = 15 respectively)) and better performance status (PS0-1 22.5 months vs PS0-4 15.3 months (95 %CI 18.7-26.1, I272.4 %, n = 11 and 95 %CI 11.5-19.1 I277.9 %, n = 13)) augmented this. For ED-SCLC the median survival was 9.6 months (95 %CI 8.9-10.3 %, I295.2 %, n = 103) and this improved when irinotecan + cisplatin was used, however studies that used this combination were mostly conducted in Asian populations where survival was better. Survival was not improved with the addition of thoracic radiotherapy or PCI. Survival for both stages of cancer was better in modern studies and Asian cohorts. It was poorer for studies administering carboplatin + etoposide but this regimen was used in studies that had fewer patient selection criteria. CONCLUSION Early thoracic radiotherapy and PCI should be offered to people with LD-SCLC in accordance with guideline recommendations. The benefit of the aforementioned therapies to treat ED-SCLC and the use of chemotherapy in people with poor PS is less clear.

中文翻译：

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对小细胞肺癌进行抗癌治疗后生存率的系统评价。

目的我们对欧洲SCLC医学肿瘤学会推荐的治疗后的生存进行了系统的回顾和荟萃分析，以确定可比较的新疗法的基准。材料和方法包括随机对照试验和观察性研究，报道SCLC化疗后的总生存期。我们计算了30天和90天的生存率以及1年，2年和中位数。结果我们确定了160个纳入对象。最少有30天死亡。在有限（LD）的90天生存率是99％（95％CI 98.0-99.0％，I233.9％，n = 77）和90％（95％CI 89.0-92.0％，I279.5％，n = 73） -SCLC）和扩展阶段（ED-SCLC）。LD-SCLC的中位生存期为18.1个月（95％CI 17.0-19.1％，I277.3％，n = 110）和早期胸腔放疗（胸腔放疗18.4个月（95％CI 17.3-19.5，I278.4％，n = 100））与未放疗11.7个月（95％CI 9.1-14.3，n = 10），预防性颅骨照射（PCI 19.7个月vs无PCI 13.0个月（分别为95％CI 18.5-21.0，I275.7％，n = 78和95％CI 10.5-16.6，I281.1％，n = 15））） （PS0-1 22.5个月vs PS0-4 15.3个月（95％CI 18.7-26.1，I272.4％，n = 11和95％CI 11.5-19.1 I277.9％，n = 13））扩大了这一点。对于ED-SCLC，中位生存期为9.6个月（95％CI 8.9-10.3％，I295.2％，n = 103），当使用伊立替康+顺铂时，这种情况有所改善，但是使用这种组合的研究主要在亚洲人群中进行生存更好的地方。胸腔放疗或PCI不能改善生存率。在现代研究和亚洲人群中，癌症两个阶段的生存率都更高。对于使用卡铂+依托泊苷的研究来说效果较差，但是该方案用于患者选择标准较少的研究中。结论LD-SCLC患者应根据指南建议进行早期胸腔放疗和PCI。上述治疗ED-SCLC的益处以及PS不良者使用化学疗法的益处尚不清楚。