Induction Immunochemotherapy Followed by Hypo-Fractionated Radiotherapy in Unresectable Stage III Non–Small Cell Lung Cancer

This study evaluated 35 patients with unresectable stage III NSCLC treated with induction immunochemotherapy and hypofractionated radiotherapy.With a median follow-up of 31.5 months, the median OS was not reached, and the median PFS was 28.0 months.The 3-year OS and PFS rates were 77.3% and 47.6%, respectively.The treatment showed promising efficacy and manageable toxicity.Purpose: To evaluate the efficacy and safety of induction immunochemotherapy followed by hypo-fractionated radiotherapy (Hypo-RT) for locally advanced unresectable non-small cell lung cancer (LA-NSCLC).Methods: This retrospective analysis involved the data of 35 patients with unresectable stage III LA-NSCLC receiving immunotherapy plus Hypo-RT from January 1, 2019, to December 31, 2023.At least 2 cycles of induction immunochemotherapy were initially administered, followed by a definitive Hypo-RT at 4 Gy per fraction.The primary endpoint was overall survival (OS) and the secondary endpoints were progression-free survival (PFS) and grade 3 nonhematologic toxicities.Time-toevent outcomes for the entire cohort were calculated using the Kaplan-Meier method.Results: At a median follow-up of 31.5 months (95% confidence interval, 26.1 to 36.9 months), median OS did not reach, with 1, 2, and 3-year OS rates of 100.0%, 82.5%, and 77.3%, respectively.Disease progression or death was recorded in 18 (51.4%)patients, with a median PFS of 28.0 months (95% CI, 9.4 to 46.6 months).The 1, 2, and 3-year PFS rates were 74.3%, 55.7%, and 47.6%, respectively.Conclusion: Induction immunochemotherapy followed by Hypo-RT demonstrated promising efficacy and acceptable toxicity in patients with LA-NSCLC.Studies on Hypo-RT combined with induction and consolidation immunotherapies are warranted in the future.