ArticleJournal of cancer research and clinical oncology2026
The efficacy and toxicity of TRT on metastatic NSCLC in patients treated with targeted therapy and chemoimmunotherapy.
Article in Journal of cancer research and clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Interpreting the apparent benefit of thoracic radiotherapy in metastatic NSCLC: patient selection and analytical issues remain important-a comment on Xue et al.Journal of cancer research and clinical oncology · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
purposeThe role of thoracic radiotherapy (TRT) combined with first-line systemic therapy for metastatic non-small cell lung cancer (NSCLC) remains controversial. Its application is not routinely recommended due to inconsistent efficacy and toxicity risks. This study aims to identify specific patients most likely to benefit from TRT in advanced NSCLC.
methodsA cohort included 523 patients with metastatic NSCLC from 2019–2024. Kaplan–Meier curves and log-rank tests were used to analyze progression-free survival (PFS) and overall survival (OS). Risk factors were identified using univariate and multivariate Cox regression analysis.
resultsThe entire cohort median OS was 60 months and median PFS was 22 months. TRT improved both PFS (25 vs. 13 months, P < 0.001) and OS (Not Reached [NR] vs. 46 months, P < 0.001). In the targeted therapy group, TRT improved PFS (27 vs. 13 months, P < 0.001) and OS (NR vs. 47 months, P < 0.001). In the chemoimmunotherapy group, TRT improved OS (NR vs. 41 months, P = 0.042) but not PFS (18 vs. 14 months, P = 0.115). Exploratory analysis found TRT increased hematologic toxicity (e.g., ≥ grade 2 lymphopenia: 67.18% vs. 11.33%, P < 0.001) and pneumonitis (any grade: 71.31% vs. 17.68%; ≥ grade 2: 17.83% vs. 4.88%, both P < 0.001). Multivariate analysis identified Planning target volume (PTV) as an independent negative predictor for PFS in the TRT group (P = 0.003).
conclusionAdding TRT to first-line systemic therapy improves survival in metastatic NSCLC. Treatment strategies should be personalized based on molecular subtype and toxicity risk.
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