小细胞肺癌（SCLC）患者历来具有较差的总生存期（OS）和高脑转移（BM）风险，但缺乏关于该人群临床表现和治疗的大规模现实证据。我们的目的是描述加拿大安大略省 SCLC 和 BM 患者的临床特征和结果。这项基于人群的回顾性队列研究包括加拿大安大略省 2010 年 4 月 1 日至 2010 年 3 月期间诊断为 SCLC 的所有患者2018年12月31日。数据分析时间为2022年6月2日至2023年12月20日。排除了第二次癌症诊断的患者。从临床评估科学研究所 (ICES) 数据库中识别患者并检索数据。进行 Kaplan-Meier 和多变量 Cox 回归分析，比较按疾病分期、BM 诊断和颅内治疗方式分层的患者队列之间的 OS。根据年龄、疾病阶段、BM 时间和接受化疗进行倾向评分匹配，以比较颅内治疗方式之间的 OS。纳入了 8705 名患者（男性：4433 例，女性：4272 例）。诊断时的中位年龄为 68 岁（四分位数间距，IQR，61-75）。所有患者的中位 OS 为 7.46 个月（95% 置信区间，CI，7.23-7.69）。 32% (n = 2686) 的患者出现 BM（同步，43.7%；异步，56.3%），中位 OS 为 9.76 个月（95% CI，9.36-10.22）。 102 名 (4%)、1654 名 (62%) 和 930 名 (35%) 患者在一线治疗或治疗中分别接受了立体定向放射外科 (SRS)、全脑放射治疗 (WBRT) 或未治疗预防性颅脑照射（PCI）后。在倾向评分匹配分析中，在未接受 PCI 的患者中，从 BM 诊断时起的 OS 在 SRS 治疗组和 WBRT 治疗组之间并不较差（风险比，HR，0.68，95% CI，0.44-1.06，p = 0.091，n = 86），并支持在 BM 发展之前接受 PCI 的患者接受 SRS（HR，0.47，95% CI，0.31-0.72，p = 0.0042，n = 112）。SCLC 患者的 OS 仍然很差，许多患者出现 BM。经过仔细选择，SCLC 和 BM 患者可能会从 SRS 治疗中受益。未来的研究应纳入有关颅内疾病负担和新型免疫疗法的信息。无。© 2024 作者。

Patients with small cell lung cancer (SCLC) have historically been characterised by poor overall survival (OS) and high risk for brain metastasis (BM), but large-scale real-world evidence on clinical presentation and treatment in this population is lacking. Our aim was to describe the clinical characteristics and outcomes of patients with SCLC and BM in Ontario, Canada.This population-based, retrospective cohort study included all patients in Ontario, Canada, who were diagnosed with SCLC between April 1, 2010, and March 31, 2018. Data were analysed between June 2, 2022, and December 20, 2023. Patients with second cancer diagnosis were excluded. Patients were identified and data retrieved from the Institute for Clinical Evaluative Sciences (ICES) databases. Kaplan-Meier and multivariable Cox regression analyses were performed to compare OS between patient cohorts stratified by disease stage, BM diagnosis, and intracranial treatment modality. Propensity score-matching based on age, disease stage, time to BM, and receipt of chemotherapy was performed to compare OS between intracranial treatment modalities.8705 patients were included (male: 4433, female: 4272). Median age at diagnosis was 68 years (interquartile range, IQR, 61-75). Median OS of all patients was 7.46 months (95% confidence interval, CI, 7.23-7.69). 32% (n = 2686) of patients developed BM (synchronous, 43.7%; asynchronous, 56.3%) with median OS of 9.76 months (95% CI, 9.36-10.22). 102 (4%), 1654 (62%), and 930 (35%) patients received stereotactic radiosurgery (SRS), whole brain radiation therapy (WBRT), or no treatment, respectively, for their BM in the first-line setting or after prophylactic cranial irradiation (PCI). In propensity score-matched analyses, OS from time of BM diagnosis was non-inferior between SRS- and WBRT-treated cohorts among patients who did not receive PCI (hazard ratio, HR, 0.68, 95% CI, 0.44-1.06, p = 0.091, n = 86) and in favour of SRS for those who received PCI prior to BM development (HR, 0.47, 95% CI, 0.31-0.72, p = 0.0042, n = 112).OS for patients with SCLC remains poor, and many patients present with BM. With careful selection, patients with SCLC and BM may benefit from SRS treatment. Future research should incorporate information on burden of intracranial disease and novel immunotherapies.None.© 2024 The Author(s).