The Efficacy and Safety of Immunotherapy Followed by Thoracic Radiation in Advanced Non-small Cell Lung Cancer: A Retrospective Analysis

Abstract

Background: The administration of thoracic irradiation has been shown to extend the overall survival rate in patients with stage IV non-small cell lung cancer (NSCLC). However, few studies have evaluated the efficacy and safety of thoracic radiotherapy combined with immunotherapy in patients with advanced NSCLC. Methods: Data pertaining to the progression-free survival (PFS), overall survival (OS), treatment response, and adverse events of 62 patients diagnosed with advanced NSCLC who underwent immunotherapy followed by thoracic radiation therapy (TRT) were retrospectively gathered. Results: The median PFS and OS were 9 and 15 months, respectively. The patients showed different treatment responses, with 5 patients (8.06%) achieving complete response (CR), 36 patients (58.06%) achieving partial response (PR), 19 patients (30.65%) showing stable disease (SD), and 2 patients (3.23%) experiencing progressive disease (PD). The patients who achieved CR or PR had longer PFS and OS than patients with SD or PD [median PFS: 11.00 vs 7.00 months, HR: 0.45 (0.22-0.91), P <0.001; median OS: not reached (NR) vs 8.00 months, HR: 0.29 (0.13-0.67), P <0.001, respectively]. Conclusions: Thoracic radiotherapy targeting the primary lesion following immunotherapy in advanced NSCLC can delay disease progression and extend survivalwhile maintaining an acceptable level of safety.