Enhancement of Prognostic Outcomes in Stage III Non-Small Cell Lung Cancer: A Retrospective Study on Neoadjuvant Immuno-Chemotherapy Followed by Definitive Chemo-Radiotherapy

IF 5 2区医学 Q2 Medicine

Translational Oncology Pub Date : 2025-04-11 DOI:10.1016/j.tranon.2025.102394

Wenxin Ding , Yechen Ma , Hao Hu , Tian Xu , Hexin Duan , Jiang Liang , Weiwei Liang , Hao Zhou , Xi Zhang , Zewen Song

{"title":"Enhancement of Prognostic Outcomes in Stage III Non-Small Cell Lung Cancer: A Retrospective Study on Neoadjuvant Immuno-Chemotherapy Followed by Definitive Chemo-Radiotherapy","authors":"Wenxin Ding , Yechen Ma , Hao Hu , Tian Xu , Hexin Duan , Jiang Liang , Weiwei Liang , Hao Zhou , Xi Zhang , Zewen Song","doi":"10.1016/j.tranon.2025.102394","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The effectiveness of neoadjuvant immuno-chemotherapy in stage III non-small cell lung cancer (NSCLC) patients undergoing definitive concurrent/sequential chemo-radiotherapy (CRT) is not well established.</div></div><div><h3>Methods</h3><div>This retrospective study involved stage III NSCLC patients treated at the Third Xiangya Hospital and Xiangxi Autonomous Prefecture People's Hospital. We compared prognosis, dosimetric outcomes, and radiation pneumonitis incidence between those receiving neoadjuvant immuno-chemotherapy and those undergoing immunotherapy maintenance after CRT. Tumor assessments were conducted on patients administered 2–4 cycles of immuno-chemotherapy, and diagnostic CT images of 54 patients were analyzed for treatment impact.</div></div><div><h3>Results</h3><div>A total of 76 patients received neoadjuvant immuno-chemotherapy followed by CRT, while 68 received immunotherapy after CRT. The median progression-free survival (PFS) for the neoadjuvant group was 29.3 months compared to 13.4 months for the maintenance group (<em>p</em> < 0.001). Median overall survival (OS) was not reached for the neoadjuvant group, while it was 37.4 months for the maintenance group (<em>p</em> = 0.004). Uni-variable analysis indicated neoadjuvant immuno-chemotherapy as an independent OS prognostic factor. The disease control rate was 99.09 %, and significant reductions in tumor volume and radiation doses to healthy tissues were observed post-treatment.</div></div><div><h3>Conclusion</h3><div>Our findings suggest neoadjuvant immuno-chemotherapy improves prognosis for stage III NSCLC patients and effectively reduces tumor volume and organ-at-risk radiation exposure, warranting further phase III trials.</div></div>","PeriodicalId":48975,"journal":{"name":"Translational Oncology","volume":"56 ","pages":"Article 102394"},"PeriodicalIF":5.0000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Translational Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1936523325001251","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Background

The effectiveness of neoadjuvant immuno-chemotherapy in stage III non-small cell lung cancer (NSCLC) patients undergoing definitive concurrent/sequential chemo-radiotherapy (CRT) is not well established.

Methods

This retrospective study involved stage III NSCLC patients treated at the Third Xiangya Hospital and Xiangxi Autonomous Prefecture People's Hospital. We compared prognosis, dosimetric outcomes, and radiation pneumonitis incidence between those receiving neoadjuvant immuno-chemotherapy and those undergoing immunotherapy maintenance after CRT. Tumor assessments were conducted on patients administered 2–4 cycles of immuno-chemotherapy, and diagnostic CT images of 54 patients were analyzed for treatment impact.

Results

A total of 76 patients received neoadjuvant immuno-chemotherapy followed by CRT, while 68 received immunotherapy after CRT. The median progression-free survival (PFS) for the neoadjuvant group was 29.3 months compared to 13.4 months for the maintenance group (p < 0.001). Median overall survival (OS) was not reached for the neoadjuvant group, while it was 37.4 months for the maintenance group (p = 0.004). Uni-variable analysis indicated neoadjuvant immuno-chemotherapy as an independent OS prognostic factor. The disease control rate was 99.09 %, and significant reductions in tumor volume and radiation doses to healthy tissues were observed post-treatment.

Conclusion

Our findings suggest neoadjuvant immuno-chemotherapy improves prognosis for stage III NSCLC patients and effectively reduces tumor volume and organ-at-risk radiation exposure, warranting further phase III trials.

查看原文本刊更多论文

提高 III 期非小细胞肺癌预后的回顾性研究：新辅助免疫化疗和确定性化疗放疗的回顾性研究

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Translational Oncology ONCOLOGY-

CiteScore

8.40

自引率

2.00%

发文量

314

审稿时长

54 days

期刊介绍： Translational Oncology publishes the results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of oncology patients. Translational Oncology will publish laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer. Peer reviewed manuscript types include Original Reports, Reviews and Editorials.