OBJECTIVES The aim of this study was to investigate the effect of preoperative radiotherapy (PrORT) on the overall survival (OS) of patients with stage ipsilateral mediastinal lymph node metastasis (N2) non-small-cell lung cancer. METHODS A total of 1390 patients with stage N2 non-small-cell lung cancer between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results database. The efficacy of PrORT combined with surgery was compared with that of surgery alone on OS. Propensity score matching (PSM) was performed to balance the baseline characteristics of patients who received (n = 239) and did not receive (n = 1151) PrORT. We compared the OS of the 2 groups using the Kaplan–Meier method and log-rank were used to compare the OS between the 2 groups test before and after PSM and to analyse subgroups of patients with squamous cell carcinoma (SCC) and adenocarcinoma. RESULTS In whole group analysis before PSM, the median OS was superior in the PrORT group than in the surgery alone group (44.0 [34.4–56.6] vs 39.0 [34.5–43.5] months). There was a significant difference in OS [hazard ratio (HR): 0.819; 95% confidence interval (CI): 0.677–0.991; P = 0.029]. Nevertheless, no statistically significant difference was found in OS between the 2 groups after PSM (HR: 0.856; 95% CI: 0.654–1.122; P = 0.260). Among subgroup analysis of the SCC group before PSM revealed that patients who received PrORT had significantly higher median OS than those who did not receive PrORT (52.0 [40.0–NA] vs 27.0 [22.0–32.0] months; HR: 0.591, 95% CI: 0.442–0.792, P = 0.000) and the differences in OS existed after PSM (P = 0.043). However, no significant difference was found in OS before and after matching in the adenocarcinoma group (P = 0.827 and P = 0.801, respectively). CONCLUSIONS PrORT demonstrated an OS benefit for patients with stage N2 lung SCC; however, further prospective randomized clinical trials are warranted to confirm this finding.

Lung squamous cell carcinoma (LUSC) is the primary pathological type of lung cancer with a less favorable prognosis. This study attempts to construct a ferroptosis-associated signature associated with overall survival (OS) that can predict the prognosis of LUSC and explore its relationship with immune infiltration. A 5 ferroptosis-associated gene model was constructed by LASSO-penalized regression analysis to predict the prognosis of patients with LUSC in the TCGA database and validated in the GEO and TCGA databases. Patients were stratified into high-risk and low-risk groups by the median value of the risk scores, and the former prognosis was significantly worse (P<0.001). Additionally, we found a certain association between the two risk groups and immune infiltration through CIBERSORT. Meanwhile, the differentially expressed genes (DEGs) between normal and tumor tissue were used to perform functional analysis, which showed a significant association with leukocyte transendothelial migration pathways in the TCGA cohort. In addition, immune cell infiltration analysis confirmed that M2 macrophages were significantly highly expressed in the high-risk group. Overall, the model successfully established by ferroptosis-associated genes suggests that ferroptosis may be related to immune infiltration in LUSC.

Since the treatment of lung squamous cell carcinoma (SCC) was limited due to a lack of appropriate biomarkers and novel target agents. Immune checkpoint inhibitors can offer an effective treatment for patients with advanced non-small cell lung cancer. Here, we described the cases of two patients with SCC who showed a good response following treatment with tislelizumab. We encountered two patients with unresectable lung SCC who were treated with immunotherapy and chemotherapy. One patient had negatively programmed death-ligand 1 expression, and the primary lesion becomes a thick wall cavity after the tislelizumab combined with chemotherapy. Another patient was diagnosed with advanced lung SCC with negative programmed death-ligand 1 expression. After the treatment, the fluorine-18-fluorodeoxyglucose PET/computed tomography indicated that no abnormal increase in radioactivity uptake and tend to complete remission. We found a significant response or even complete response in unresectable SCC treated with tislelizumab combined with chemotherapy. Our cases added evidence of the feasibility and efficacy of tislelizumab combined with chemotherapy in unresectable lung SCC.

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Lung squamous cell carcinoma (LUSC) is the primary pathological type of lung cancer with a less favourable prognosis. This study attempts to construct a ferroptosis-associated signature associated with OS, which can predict the prognosis of LUSC and explore its relationship with immune in-filtration. A 5 ferroptosis-associated genes model was constructed by the LASSO-penalized regres-sion analysis to predict the prognosis of patients with LUSC in the TCGA database and validated in GEO and TCGA databases. Patients were stratified into high-risk and low-risk groups by median value of the risk scores, and the former prognosis was significantly worse (P<0.001). Additionally, we found a certain association between the two risk groups and immune infiltration through CIBERSORT. Meanwhile, the differentially expressed genes (DEGs) between normal and tumor tissue were used to perform functional analysis, which shows significant association with leukocyte transendothelial migration pathways in the TCGA cohort. Besides, immune cell infiltration analysis confirmed that M2 macrophages were significantly highly expressed in the high-risk group. Overall, the model successfully established by ferroptosis-associated genes suggests that ferroptosis may be related to immune infiltration in LUSC.