Efficacy and safety of immunotherapy combined with chemoradiotherapy in limited-stage small cell lung cancer: a systematic evaluation and meta-analysis of randomized controlled trials.

Concurrent chemoradiotherapy (cCRT) remains the standard treatment for patients diagnosed with limited-stage small-cell lung cancer (LS-SCLC); however, recurrence rates remain high and prognosis remains poor. This study collected data regarding patient-reported outcomes and adverse events (AEs) to evaluate the effects of chemoradiotherapy combined with immunotherapy in patients with LS-SCLC. A systematic literature search of 7 electronic databases was conducted for randomized, placebo-controlled trials enrolling patients diagnosed with LS-SCLC who received chemoradiotherapy combined with immunotherapy. Trials with unstratified LS-SCLC samples were excluded. A subsequent meta-analysis was performed. This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) under accession number CRD42024607159. Nine trials comprising 1,853 patients were included. CCRT combined with immunotherapy exhibited a significant favorable trend in survival outcomes, with hazard ratios (HRs) for median progression-free survival (mPFS) and median overall survival (mOS) of 0.838 (95% confidence interval [CI]: 0.742-0.947) and 0.847 (95% CI: 0.736-0.975), especially in the consolidation group with HRs for mPFS and mOS of 0.793 (95% CI: 0.675-0.930) and 0.757 (95% CI: 0.551-1.040), respectively. CCRT combined with immunotherapy improved survival in patients with LS-SCLC, especially in the consolidation immunotherapy group. The treatment regimen was generally well tolerated, with an acceptable incidence of treatment-related adverse events (TRAEs). https://www.crd.york.ac.uk/prospero/, identifier CRD42024607159.