Induction chemoimmunotherapy followed by radiotherapy and consolidation immunotherapy versus definitive concurrent chemoradiotherapy with consolidation immunotherapy for unresectable stage III non-small cell lung cancer: A single-center retrospective study.

In clinical practice, patients with unresectable stage III non-small cell lung cancer (NSCLC) often exhibit limited tolerance to concurrent chemoradiotherapy (cCRT). This retrospective study evaluated the efficacy and safety of induction chemoimmunotherapy followed by definitive radiotherapy (RT) and consolidation immunotherapy, compared with standard cCRT plus consolidation immunotherapy. A total of 102 patients treated at West China Hospital between June 2019 and June 2024 were analyzed. Primary endpoints were overall survival (OS) and progression-free survival (PFS); secondary endpoints included objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events (TRAEs). Survival outcomes were comparable between groups (median OS: not reached vs. 36 months, p = 0.52; median PFS: 25 vs. 28 months, p = 0.71), with higher 3-year OS observed in the induction group (61.4% vs. 38.3%). In the induction group, ORR after systemic therapy was 74.2%, and post-RT DCR reached 83.3%. TRAEs were comparable across groups, with pneumonitis being the most frequent toxicity and no significant increase in grade ≥3 events observed. These findings support the induction-based sequential strategy as a viable alternative to cCRT for patients with unresectable stage III NSCLC, especially those unsuitable for concurrent treatment.