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Background  Small-cell lung cancer (SCLC) is a highly proliferative, rapidly growing tumor with a poor prognosis, even in cases of limited disease (LD). Timely and accurate high-intensity therapy is necessary. For concurrent chemoradiotherapy (CCRT), etoposide/platinum (EP)-based regimens are recommended, although irinotecan/platinum (IP)-based regimens are also effective with radiotherapy. This large-scale, retrospective, nationwide cohort study aimed to analyze the efficacy of CCRT in patients with LD-SCLC.    Methods  Population data registered between January 2008 and December 2018 was extracted from the Health Insurance Review and Assessment Service of Korea database. Survival outcomes of 4446 LD-SCLC patients who received CCRT were analyzed.    Results  Patients who received EP-CCRT ( n  = 4187) showed better time to first subsequent therapy (TFST: 11.2 months) and overall survival (OS: 22.2 months) than those who received IP-CCRT ( n  = 259; TFST: 9.6 months,  P  = 0.0477; OS: 16.4 months,  P  <  0.0001). When CCRT failed, dual-agent chemotherapy ( n  = 925; OS: 9.1 months) provided a better survival benefit than single-agent chemotherapy ( n  = 815; OS: 7.5 months). IP-based chemotherapy resulted in better OS (9.6 months) than EP-based chemotherapy (7.1 months,  P  = 0.017) in platinum-resistant relapsed patients; the opposite was observed for platinum-sensitive relapsed patients (OS: EP, 17.2 months; IP, 6.6 months;  P  <  0.0001). Poisson regression analysis demonstrated that age, EP-CCRT, and hypercholesterolemia retained significant associations with OS after adjustment for all variables.    Conclusion  In the Korean population, the effects of EP-CCRT on OS and TFST are significantly more favorable than those of IP-CCRT.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12885-021-08082-2.

bmc cancer

Efficacy of concurrent chemoradiotherapy for patients with limited-disease small-cell lung cancer: a retrospective, nationwide, population-based cohort study