ArticleThoracic cancer2026
Programmed Death-Ligand 1 Expression Predicts Poor Prognosis in Patients With Early-Stage Non-Small-Cell Lung Cancer Undergoing Stereotactic Body Radiotherapy.
Article in Thoracic cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStereotactic body radiotherapy (SBRT) is the standard treatment for medically inoperable early-stage, non-small-cell lung cancer (NSCLC). Programmed death-ligand 1 (PD-L1) is a well-known biomarker for predicting immunotherapy responses; however, its prognostic significance in early-stage NSCLC treated with SBRT remains unclear. Here, we evaluated the prognostic significance of PD-L1 expression in this setting.
methodsWe retrospectively analyzed patients with early-stage NSCLC who underwent SBRT. PD-L1 expression was assessed using the SP263 immunohistochemistry assay and quantified by tumor proportion score. We evaluated the prognostic impact of PD-L1 as a continuous variable and used an exploratory 2% cutoff derived from receiver operating characteristic analysis. Clinical outcomes, including local recurrence-free survival (LRFS), recurrence-free survival (RFS), disease-free survival (DFS), and overall survival (OS), were compared. Cox proportional hazards models were used for multivariable analysis.
resultsA total of 54 patients were included. SBRT achieved a 2-year LRFS rate of 98%. As a continuous variable, higher PD-L1 expression was independently associated with inferior RFS (hazard ratio (HR): 1.07, p < 0.01), DFS (HR: 1.06, p < 0.01), and OS (HR: 1.04, p < 0.01). The PD-L1-positive group had a higher incidence of regional recurrence (30.0% vs. 5.9%, p = 0.041). The exploratory 2% cutoff identified a subgroup with significantly worse survival in univariable analyses, although it did not retain independent significance in the multivariable analysis.
conclusionsPD-L1 expression is independently associated with worse survival outcomes in patients with early-stage NSCLC treated with SBRT, indicating its potential as a prognostic biomarker for risk stratification.
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