The impact of comprehensive local therapy on treatment outcomes of non-small cell lung cancer with solitary skeletal oligometastasis.

Background: The oligometastatic status of non-small lung cancer (NSCLC) has been extensively studied over the years owing to its potential significance in long-term survival. Bone is one of the most commonly affected organs in oligometastatic NSCLC. The value of comprehensive local therapy (CLT) for NSCLC with solitary skeletal oligometastasis remains to be established. Methods: Data on NSCLC cases with solitary skeletal oligometastasis were collected retrospectively between August 2008 and March 2022. Kaplan-Meier and Cox regression analyses were performed to assess clinical outcomes. Results: Sixty-seven patients were included in the final analysis, 23 (34.3 %) of whom received CLT. Median progression-free survival (PFS) and overall survival (OS) were 9.9 and 27.1 months for the non-CLT cohort and 18.8 and 46.0 months for the CLT cohort, respectively. In multivariate analysis, CLT emerged as an independent prognostic factor associated with improved PFS (P = 0.031), but had no significant correlation with OS (P = 0.403). Among 23 patients treated with EGFR-TKIs, the CLT group had a median PFS of 46.8 months and a median OS that was not reached, while the non-CLT group had a median PFS of 15.7 months and a median OS of 30.7 months. CLT plus EGFR-TKI significantly improved PFS versus monotherapy (P = 0.023), though OS did not differ significantly (P = 0.095). Conclusions: In NSCLC patients with solitary skeletal oligometastasis, implementation of CLT appeared to positively influence PFS. The combination of EGFR-TKI and CLT was associated with prolonged PFS compared to EGFR-TKI alone, though further validation is needed to confirm its impact on long-term survival.