Objective To evaluate the efficacy and safety of Anlotinib combined with Capecitabine/Temozolomide in the treatment of advanced SCLC brain metastasis after multi-line therapy.Methods A total of 23 SCLC patients who developed brain metastases after second-line chemotherapy in the First People′s Hospital of Longquanyi District Chengdu from August 2018 to August 2021 were included, and the posterior treatment regimen was given Anlotinib targeted therapy combined with CAPTEM antitumor therapy.The progression-free survival time(PFS), intracranial progression-free survival time(iPFS), objective response rate(ORR), disease control rate(DCR), and intracranial objective response rate(iORR) were observed, and univariate analysis was performed.The PFS and iPFS of the patients were included by COX multivariate regression analysis.Kaplan-Meier method was used for survival analysis of relevant data to evaluate the efficacy and safety of the combined regimen for the posterior line treatment of advanced SCLC brain metastases.Results Curative effect analysis: Among the 23 patients, 0 cases had complete remission, 10 cases had partial remission, 10 cases had stable disease, and three cases had disease progression.The ORR was 43.47% and the DCR was 86.95%.Brain metastasis evaluation: of the 23 patients, 0 were in complete remission, 11 were in partial remission, 10 were in stable condition, and two were in disease progression, with an iORR of 47.82%.The median PFS was 6.4(5.4, 7.0) months and iPFS was 6.5(5.5, 7.4) months.Univariate analysis: Smoking and other adverse lifestyle, physical status Easten Cooperative Oncology Group(ECOG) score and brain radiotherapy had some effects on PFS(P＜0.05), while physical status ECOG score and simultaneous intracranial metastatic radiotherapy were associated with iPFS(P＜0.05).Polyfactor analysis: physical status ECOG score of body dynamics had significant effects on PFS and iPFS of patients(P＜0.01).There were no grade four adverse events in 23 patients, and the common adverse reactions were hand-foot syndrome [30.43%(7/23)], oral mucositis [17.39%(4/23)], hypertension [26.08%(6/23)], gastrointestinal reactions [30.43%(7/23)], and loss of appetite [21.73%(5/23)], diarrhea [13.04%(3/23)], all of which were grade one to two; one patient developed grade three hypertensive adverse events, which were well controlled after prescribed hypertension drugs and responded well after dose adjustment.No severe adverse reactions such as hemoptysis and intracranial hemorrhage occurred in all patients.Conclusion Anlotinib combined with CAPTEM can benefit SCLC patients with brain metastases in the after-line treatment, and has a good safety. [ABSTRACT FROM AUTHOR]