Six-year survival after oral temozolomide maintenance therapy in limited-stage small cell lung cancer: A case report.

Small cell lung cancer (SCLC) accounts for 13-17% of lung cancer cases and is characterized by poor differentiation, high malignancy and a propensity for recurrence and metastasis. Limited-stage SCLC (LS-SCLC) typically has a better prognosis than extensive-stage SCLC due to its localized nature. However, even with standard concurrent chemoradiotherapy, the median overall survival (OS) for LS-SCLC is only 30 months, with a 5-year survival rate of merely 29-34%. The present study reported the case a patient with LS-SCLC who received oral temozolomide (TMZ) maintenance therapy, achieving an impressive 6-year survival without disease progression or significant side effects. Factors contributing to this outcome include the cytotoxic effects of TMZ and its potential preventive and therapeutic roles in managing brain metastases. In addition, durvalumab has been proven to prolong OS as maintenance therapy after first-line chemoradiotherapy in patients with LS-SCLC. In the future, maintenance therapy for SCLC should explore combination drug strategies, as integrating TMZ or poly(ADP-ribose) polymerase inhibitors with immunotherapy may enhance patient survival.