| Du Zhe,Zhao Yuting,Shi Anhui,et al.Impact of immune checkpoint inhibitors combined with thoracic radiotherapy on the survival of patients with synchronous oligometastatic non-small cell lung cancer[J].Chinese Journal of Radiological Medicine and Protection,2025,45(7):637-646 |
| Impact of immune checkpoint inhibitors combined with thoracic radiotherapy on the survival of patients with synchronous oligometastatic non-small cell lung cancer |
| Received:March 03, 2025 |
| DOI：10.3760/cma.j.cn112271-20250303-00070 |
| KeyWords:Non-small cell lung cancer (NSCLC) Synchronous oligometastasis Immune checkpoint inhibitor (ICI) Thoracic radiotherapy Survival outcome |
| FundProject:北京市医院管理中心临床医学发展专项经费(ZLRK202327) |
| Author Name | Affiliation | E-mail | | Du Zhe | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China | | | Zhao Yuting | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China | | | Shi Anhui | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China | | | Yu Huiming | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China | | | Yu Rong | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China | | | Wang Weihu | Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Beijing 100142, China | wangweihu88@163.com |
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| Abstract:: |
| Objective To investigate the prognostic value and safety of thoracic radiotherapy in patients with synchronous oligometastatic, driver gene-negative non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors (ICIs) as first-line treatment. Methods Data were retrospectively collected from 55 patients diagnosed with synchronous oligometastatic, driver gene-negative NSCLC who received first-line ICIs from January 2017 to March 2022. These patients were categorized into two groups based on the administration of thoracic radiotherapy: the thoracic radiotherapy group (n = 27) and the non-thoracic radiotherapy group (n = 28). Comparative analyses were conducted to evaluate survival outcomes and safety profiles between the two groups. Results Among the 55 patients, 27 (49.1%) received thoracic radiotherapy. The median follow-up time was 37.0 months (2.2-76.7 months). Patients in the thoracic radiotherapy group exhibited significantly improved median overall survival (OS: 53.4 vs. 21.3 months, P = 0.049) and median progression-free survival (PFS: 13.6 vs. 8.3 months, χ2=4.11,P = 0.043) compared to those in the non-thoracic radiotherapy group. Multivariate Cox regression analysis identified thoracic radiotherapy as an independent prognostic factor for OS (HR = 0.39, 95% CI: 0.17-0.90, P = 0.027) and PFS (HR = 0.53, 95% CI: 0.28-0.99, P = 0.046). The most common grade 3 or higher toxicity was bone marrow suppression, occurring in seven patients (12.7%). There was no significant difference between both groups in the incidence of grade 3 or higher treatment-related adverse events, including pneumonitis.Conclusion In patients with driver gene-negative, synchronous oligometastatic NSCLC, first-line immunotherapy combined with thoracic radiotherapy may improve survival outcomes without increasing the incidence of severe treatment-related adverse events. Further large-scale, randomized prospective trials are needed to verify the findings of this study. |
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