Song Ruiqiang, Chen Zhixiang, Zheng Tianxi, Huang Jingfei, Cheng Yanbo
Department of Thoracic Surgery, The Third People's Hospital of Zhengzhou, Zhengzhou, 450000, Henan, People's Republic of China.
Department of Thoracic Surgery, The Eighth Affiliated Hospital of Xinjiang Medical University, Urumqi, 830000, Xinjiang Uygur Autonomous Region, People's Republic of China.
Sci Rep. 2025 Jul 31;15(1):28003. doi: 10.1038/s41598-025-13917-0.
The prognosis for stage IIIa non-small cell lung cancer (NSCLC) remains poor, necessitating innovative treatment strategies to improve patient outcomes. This study evaluates the efficacy of neoadjuvant immunotherapy combined with chemotherapy in enhancing resection rates, survival, and progression-free survival in patients with stage IIIa NSCLC. A retrospective analysis was conducted on 82 patients treated at The Third People's Hospital of Zhengzhou, Henan, China, between October 2018 and April 2019. Patients were divided into two groups: an experimental group (n = 41) treated with a combination of platinum-based chemotherapy (pemetrexed and nedaplatin) and the PD-1 inhibitor cindilizumab, and a control group (n = 41) treated with conventional platinum-based chemotherapy. The experimental group demonstrated a significantly higher objective response rate, superior R0 resection rates, and fewer metastatic lymph nodes compared to the control group. Postoperative complications were significantly reduced in the experimental group, accompanied by substantial reductions in tumor markers, including cytokeratin 19 fragments and carbohydrate antigen 125. Median overall survival and progression-free survival were longer in the experimental group than in the control group. Hematological safety was confirmed with no significant differences in routine blood counts between the two groups before or after treatment. These findings support the integration of neoadjuvant immunotherapy and chemotherapy as a promising strategy for treating stage IIIa NSCLC, offering improved resection rates, survival, and reduced complications. Further research is warranted to optimize treatment protocols and validate these results in larger, multicentre studies.
Ⅲa期非小细胞肺癌（NSCLC）的预后仍然很差，因此需要创新的治疗策略来改善患者的治疗效果。本研究评估了新辅助免疫疗法联合化疗在提高Ⅲa期NSCLC患者的切除率、生存率和无进展生存期方面的疗效。对2018年10月至2019年4月在中国河南郑州第三人民医院接受治疗的82例患者进行了回顾性分析。患者分为两组：实验组（n = 41）接受铂类化疗（培美曲塞和顺铂）与PD-1抑制剂信迪利单抗联合治疗，对照组（n = 41）接受传统铂类化疗。与对照组相比，实验组的客观缓解率显著更高，R0切除率更高，转移淋巴结更少。实验组术后并发症显著减少，同时肿瘤标志物包括细胞角蛋白19片段和糖类抗原125也大幅降低。实验组的中位总生存期和无进展生存期均长于对照组。血液学安全性得到证实，两组治疗前后血常规无显著差异。这些发现支持新辅助免疫疗法与化疗相结合是治疗Ⅲa期NSCLC的一种有前景的策略，可提高切除率、生存率并减少并发症。有必要进行进一步研究以优化治疗方案，并在更大规模的多中心研究中验证这些结果。
