Stereotactic Radiosurgery (SRS) for Small Cell Lung Cancer (SCLC) brain metastases: a real-world UK tertiary centre experience.

Approximately 60% of patients with small cell lung cancer (SCLC) develop brain metastases(BM). Historically these have been managed with whole brain radiotherapy. FIRE-SCLC study provides a benchmark for survival with SRS, demonstrating a median overall survival(mOS) of 8.5 months(m). We conducted a retrospective analysis of a prospectively collected dataset of patients with SCLC receiving stereotactic radiosurgery (SRS) for BM at our centre from 05/2016-10/2024. The primary objective was mOS. Survival analysis was calculated from time of first SRS to death, performed on Prism 10.1.1,.Extraction from electronic medical records was undertaken by authors, with local R&D approval. 40 patients were evaluable. 20% of patients (N = 8/40) received multiple treatments. Median follow up time was 8.7 m. Median OS was 10.0 m. mOS of patients with 1 lesion was 13.8 m, vs 8.4 and 8.7 m for 2-4 and 5-10 BM.mOS for patients with KPS ≥ 90 12.4 m vs 8.7 m for those with KPS ≤ 80 (HR 1.63, P = 0.15). There was one death within 28 days of SRS. 5 patients died within 90 days of SRS. Median OS in this cohort of patients with SCLC BM compared favourably to the FIRE-SCLC cohort, supporting consideration in selected patients. Our cohort was limited by sample size. Further prospective research is needed to guide local therapies in ES-SCLC BM, particularly regarding adverse events. UK real-world data demonstrate survival outcomes with SRS for SCLC BM was comparable to FIRE-SCLC, supporting feasibility under NHS commissioning criteria.