Real-world outcomes of consolidative radiotherapy following first-line chemo-immunotherapy in metastatic non-small cell lung cancer: a retrospective cohort study.

The role and efficacy of consolidative radiotherapy (CRT) in patients with metastatic non-small cell lung cancer (mNSCLC) treated with first-line chemo-immunotherapy remain to be clarified. In this retrospective cohort study, we divided mNSCLC patients who achieved disease control with initial chemo-immunotherapy into CRT and non-CRT groups. Propensity score matching was employed to balance baseline characteristics. Results showed that the median overall survival (OS) was significantly longer in the CRT group (38.5 months) compared to the non-CRT group (25.1 months) (HR=0.48, P=0.004). Similarly, median progression-free survival (PFS) was 16.2 months in the CRT group versus 9.8 months in the non-CRT group (HR=0.52, P=0.005). CRT was identified as an independent favorable prognostic factor, with OS benefits consistent across all subgroups. Safety analysis revealed no significant difference in the incidence of grade ≥3 adverse events between the groups. These findings indicate that consolidative radiotherapy following first-line chemo-immunotherapy is associated with significantly improved survival outcomes in mNSCLC patients, demonstrating a favorable risk-benefit profile in real-world practice.