Objective  To investigate the clinical benefits of prophylactic supraclavicular irradiation (PSCI) in high-risk patients with limited-stage small cell lung cancer (LS-SCLC).

  Methods  LS-SCLC patients without supraclavicular lymph node (SCLN) involvement and treated with concurrent chemoradiation in the Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, between July 2006 and July 2011, were retrospectively analyzed. According to our previous study, some were defined as SCLN recurrence high-risk patients. The recurrence rates of SCLN involvement and cancer-specific overall survival (CSS) in the different cohorts were observed. Univariate and multivariate analyses were performed both in the whole cohort and high-risk patients with recurrent SCLN involvement.

  Results  One-hundred and one patients with a median age of 57 years were included. As many as 50% of the high-risk patients had recurrent SCLN involvement at the last follow-up as compared to 13.6% of the low-risk patients. The patients with recurrent SCLN involvement had a dramatically lower five-year CSS than those without recurrent SCLN involvement. The five-year CSS of highrisk patients with PSCI was similar to that of the low-risk patients; however, it was significantly higher than the five-year CSS of the high-risk patients without PSCI. The multivariate analysis revealed that advanced stage and recurrent SCLN involvement were significantly associated with poor CSS in the overall cohort. In the high-risk patients with recurrent SCLN involvement alone, only PSCI was associated with improved CSS.

  Conclusions  PSCI not only reduced the recurrence of SCLN involvement significantly but also improved CSS in high-risk patients with LS-SCLC.