小细胞肺癌（SCLC）患者在肿瘤负荷、身体状况和对初始治疗的反应方面表现出显着的异质性。治疗反应的这种多样性可能会导致不同的治疗结果。本研究的主要目的是探讨与通过放疗改善生存结果相关的患者人口统计数据。基于SEER数据库，我们确定了2004年至2015年间入组的42,824名SCLC患者。这些患者被分为放疗组（n = 20,360）和非放疗组（n = 22,464）。我们使用倾向评分匹配（PSM）分析来控制混杂因素。随后，采用Kaplan-Meier（KM）分析来评估放疗对患者总生存期（OS）和癌症特异性生存期（CSS）的影响。使用竞争风险模型进一步分析了癌症特异性死亡率。还进行了 Cox 分析，以检查可能影响 SCLC 患者生存的其他变量。我们总共确定了 42,824 名符合条件的患者，在 PSM 后，放疗组和非放疗组中有 13,329 名患者成功匹配。 KM 分析显示，放疗组的中位 OS 为 9 个月，非放疗组为 6 个月。放疗组的中位 CSS 为 10 个月，非放疗组为 7 个月。放疗组5年OS率和10年OS率分别为6.2%和1.6%，非放疗组分别为2.6%和0.8%（P<0.001）。竞争风险分析显示，非放疗组的癌症特异性死亡率显着高于放疗组（P < 0.001）。多变量Cox分析显示，放疗组（相对非放疗组）对生存结局表现出显着的正向影响（OS：HR 0.658 95% CI [0.642，0.675] P < 0.001；CSS：HR 0.662 95% CI [0.645， 0.679]，P < 0.001）。此外，年龄、性别、种族、原发肿瘤部位、T分期、N分期、M分期、化疗和手术也被认为是SCLC结局的重要预测因素。亚组分析结果显示，无论年龄、性别、种族、原发肿瘤部位、M分期、化疗和手术，放疗组均表现出显着的生存优势（P<0.001）。放疗可以改善 SCLC 患者的 OS 和 CSS。无论年龄、性别、种族、原发肿瘤部位、M 分期、化疗和手术，SCLC 患者都可能受益于放疗。© 2024。作者。

Small cell lung cancer (SCLC) patients exhibit significant heterogeneity in tumor burden, physical condition, and responses to initial treatment. This diversity in treatment responses can result in varying treatment outcomes. The primary objective of this study was to explore the patient demographics associated with improved survival outcomes through radiotherapy. Based on the SEER database, we identified 42,824 SCLC patients enrolled between 2004 and 2015. These patients were stratified into radiotherapy (n = 20,360) and non-radiotherapy groups (n = 22,464). We controlled for confounding factors using propensity score matching (PSM) analysis. Subsequently, Kaplan-Meier (KM) analysis was employed to evaluate the impact of radiotherapy on patients' overall survival (OS) and cancer-specific survival (CSS). Cancer-specific mortality was further analyzed using competitive risk models. Cox analysis was also conducted to examine additional variables potentially affecting the survival of SCLC patients. We identified a total of 42,824 eligible patients, and following PSM, 13,329 patients were successfully matched in both the radiotherapy and non-radiotherapy groups. The KM analysis showed that the median OS was 9 months in the radiotherapy group and 6 months in the non-radiotherapy group. The median CSS was 10 months in the radiotherapy group and 7 months in the non-radiotherapy group. The 5-year OS and 10-year OS rates were 6.2% versus 1.6% in the radiotherapy group and 2.6% versus 0.8% in the non-radiotherapy group (P < 0.001). Competitive risk analysis showed that cancer-specific mortality was significantly higher in the non-radiotherapy group than in the radiotherapy group (P < 0.001). Multivariate Cox analysis showed that the radiotherapy group (relative non-radiotherapy group) showed a significant positive effect on survival outcomes (OS: HR 0.658 95% CI [0.642, 0.675] P < 0.001; CSS: HR 0.662 95% CI [0.645, 0.679], P < 0.001). In addition, age, gender, race, primary tumor site, T stage, N stage, M stage, chemotherapy, and surgery were also considered as important predictors of SCLC outcome. The results of the subgroup analysis showed that the radiotherapy group showed a significant survival advantage regardless of age, sex, race, primary tumor site, M stage, chemotherapy, and surgery (P < 0.001). Radiotherapy may improve both OS and CSS in SCLC patients. Patients with SCLC may benefit from radiotherapy regardless of age, sex, race, primary tumor site, M stage, chemotherapy, and surgery.© 2024. The Author(s).