ArticleTherapeutic advances in medical oncology2026
Definitive radiotherapy provides comparable survival with lower toxicity compared with concurrent chemoradiotherapy after long-course induction chemoimmunotherapy in unresectable non-small-cell lung cancer.
Article in Therapeutic advances in medical oncology, 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
Background: Long-course induction chemoimmunotherapy (⩾3 cycles) is increasingly used to downstage unresectable non-small-cell lung cancer (NSCLC). However, the optimal definitive local treatment for patients who remain inoperable after induction-definitive radiotherapy (RT) alone versus concurrent chemoradiotherapy (CRT)-remains unclear. Objectives: To compare survival and toxicity outcomes between definitive RT and CRT following induction chemoimmunotherapy in unresectable NSCLC. Design: This was a single-center retrospective cohort study using stable inverse probability of treatment weighting (sIPTW) to balance baseline characteristics between treatment groups. Methods: Consecutive patients with unresectable NSCLC without known actionable driver mutations who remained inoperable after long-course induction chemoimmunotherapy and subsequently received definitive RT or CRT were included. Progression-free survival (PFS) and overall survival (OS) were estimated using Kaplan-Meier methods and compared with weighted Cox proportional hazards models. Treatment-related adverse events were graded according to the Common Terminology Criteria for Adverse Events. An exploratory analysis evaluated the association between consolidation immunotherapy and PFS. Results: A total of 153 patients were included (RT, Conclusion: In patients with unresectable NSCLC who remain inoperable after long-course induction chemoimmunotherapy, definitive RT alone provides survival outcomes comparable to CRT while reducing severe hematologic toxicity. RT alone may represent a reasonable definitive option for carefully selected patients in this setting.
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