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已发表论文
免疫检查点抑制剂联合序贯放疗治疗局部晚期非小细胞肺癌伴多器官免疫相关不良事件的持久肿瘤控制：一例报告
Authors Zhai M, Liu X, Li Y, Pi G, Bi J, Han G
Received 10 August 2025
Accepted for publication 2 December 2025
Published 10 December 2025 Volume 2025:14 Pages 1411—1417
DOI https://doi.org/10.2147/ITT.S559801
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Sarah Wheeler
Menglan Zhai,1,* Xianwen Liu,2,* Ying Li,1 Guoliang Pi,1 Jianping Bi,1 Guang Han1
1Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Oncology, Zhongxiang Traditional Chinese Medicine Hospital, Jingmen, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianping Bi, Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Tel +86-27-8767-1510, Email bixia2007112@163.com Guang Han, Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Tel +86-27-8767-0023, Email hg7913@hotmail.com
Abstract: Combining radiotherapy (RT) with immune checkpoint inhibitors (ICIs) improves survival in stage III non-small cell lung cancer (NSCLC), though immune-related adverse events (irAEs) require vigilant management. Emerging evidence suggests multi-organ irAEs may correlate with favorable outcomes. We report a case of unresectable stage IIIA NSCLC achieving sustained partial response (PR) with progression-free survival (PFS) exceeding 42 months after one cycle of pembrolizumab-chemotherapy followed by sequential thoracic RT (50 Gy/25 fractions). Severe multi-organ irAEs (muscular, cardiovascular, respiratory, hematologic) developed but were effectively managed with corticosteroid-based therapy. Remarkably, durable tumor control persisted despite suboptimal therapeutic dosing and early systemic treatment discontinuation. This case demonstrates that RT-ICI synergy can induce robust systemic antitumor immunity even with dose-reduced RT, while severe multi-system irAEs may signal favorable prognosis. These findings support optimizing RT parameters (eg, dose de-escalation, target volume refinement) as a viable approach in the immunotherapy era.
Keywords: non-small cell lung cancer, immune checkpoint inhibitor, radiotherapy, immune-related adverse events, long-term survival
1Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Department of Oncology, Zhongxiang Traditional Chinese Medicine Hospital, Jingmen, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Jianping Bi, Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Tel +86-27-8767-1510, Email bixia2007112@163.com Guang Han, Department of Radiation Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China, Tel +86-27-8767-0023, Email hg7913@hotmail.com
Abstract: Combining radiotherapy (RT) with immune checkpoint inhibitors (ICIs) improves survival in stage III non-small cell lung cancer (NSCLC), though immune-related adverse events (irAEs) require vigilant management. Emerging evidence suggests multi-organ irAEs may correlate with favorable outcomes. We report a case of unresectable stage IIIA NSCLC achieving sustained partial response (PR) with progression-free survival (PFS) exceeding 42 months after one cycle of pembrolizumab-chemotherapy followed by sequential thoracic RT (50 Gy/25 fractions). Severe multi-organ irAEs (muscular, cardiovascular, respiratory, hematologic) developed but were effectively managed with corticosteroid-based therapy. Remarkably, durable tumor control persisted despite suboptimal therapeutic dosing and early systemic treatment discontinuation. This case demonstrates that RT-ICI synergy can induce robust systemic antitumor immunity even with dose-reduced RT, while severe multi-system irAEs may signal favorable prognosis. These findings support optimizing RT parameters (eg, dose de-escalation, target volume refinement) as a viable approach in the immunotherapy era.
Keywords: non-small cell lung cancer, immune checkpoint inhibitor, radiotherapy, immune-related adverse events, long-term survival