Objective:To evaluate the effects of sequential immunotherapy with radiotherapy on survival time and immune function in patients with unresectable stage III non-small cell lung cancer (NSCLC) in a real-world study.Methods:Data of 84 patients with unresectable stage III NSCLC who were treated at the Affiliated Hospital of Inner Mongolia Medical University from January 2021 to December 2022 (retrospective cohort) and from January 2023 to December 2023 (prospective cohort) were collected. The patients were divided into the combination group ( n=40) and radiotherapy group ( n=44) based on whether they received sequential immunotherapy or not. The progression-free survival (PFS) and overall survival (OS) between two groups were compared using standardized mortality ratio weighting (SMRW). Univariate Cox proportional hazards model, multivariate regression analysis, multi-model comparison of propensity score matching and subgroup analysis were emploed to analyze the robustness of clinical efficacy between two groups. E-value analysis was used to analyze the sensitivity of unmeasured confounding factors in observational studies. Additionally, the percentage of CD4 +T cells, CD8 +T cells and natural killer (NK) cells, and CD4 +/CD8 + T cell ratio before and after treatment between two groups were compared using analysis of covariance. Results:Among 84 patients, 77 (92%) cases were male and 7 (8%) were female. Among them, 42 (50%) were aged 65 years or older. The variables showed high homogeneity after SMRW, with a standardized mean difference of less than 0.1. In the combination group, the median PFS [17.0 months vs. 7.0 months, HR=0.260, 95% CI: 0.130-0.490, P<0.001] and OS [not reached vs. 24.0 months, HR=0.210, 95% CI: 0.070-0.590, P=0.002] were significantly longer compared to that in the radiotherapy group, with statistically significant differences. The study results were confirmed by robustness and sensitivity analyses. After treatment, patients in the combination group showed a statistically significant increase in the percentage of CD4 + T cells and NK cells, and CD4 +/CD8 + T cell ratio, as well as a decrease in the percentage of CD8 + T cells compared to those in the radiotherapy group (all P<0.05). Conclusions:Sequential immunotherapy following radiotherapy can significantly improve survival and prognosis of unresectable stage III NSCLC patients. The survival benefit is even greater when combined with chemotherapy. The main mechanism of the survival benefit may be the improvement of anti-tumor immune function.

Objective:To evaluate the effects of sequential immunotherapy with radiotherapy on survival time and immune function in patients with unresectable stage III non-small cell lung cancer (NSCLC) in a real-world study.Methods:Data of 84 patients with unresectable stage III NSCLC who were treated at the Affiliated Hospital of Inner Mongolia Medical University from January 2021 to December 2022 (retrospective cohort) and from January 2023 to December 2023 (prospective cohort) were collected. The patients were divided into the combination group ( n=40) and radiotherapy group ( n=44) based on whether they received sequential immunotherapy or not. The progression-free survival (PFS) and overall survival (OS) between two groups were compared using standardized mortality ratio weighting (SMRW). Univariate Cox proportional hazards model, multivariate regression analysis, multi-model comparison of propensity score matching and subgroup analysis were emploed to analyze the robustness of clinical efficacy between two groups. E-value analysis was used to analyze the sensitivity of unmeasured confounding factors in observational studies. Additionally, the percentage of CD4 +T cells, CD8 +T cells and natural killer (NK) cells, and CD4 +/CD8 + T cell ratio before and after treatment between two groups were compared using analysis of covariance. Results:Among 84 patients, 77 (92%) cases were male and 7 (8%) were female. Among them, 42 (50%) were aged 65 years or older. The variables showed high homogeneity after SMRW, with a standardized mean difference of less than 0.1. In the combination group, the median PFS [17.0 months vs. 7.0 months, HR=0.260, 95% CI: 0.130-0.490, P<0.001] and OS [not reached vs. 24.0 months, HR=0.210, 95% CI: 0.070-0.590, P=0.002] were significantly longer compared to that in the radiotherapy group, with statistically significant differences. The study results were confirmed by robustness and sensitivity analyses. After treatment, patients in the combination group showed a statistically significant increase in the percentage of CD4 + T cells and NK cells, and CD4 +/CD8 + T cell ratio, as well as a decrease in the percentage of CD8 + T cells compared to those in the radiotherapy group (all P<0.05). Conclusions:Sequential immunotherapy following radiotherapy can significantly improve survival and prognosis of unresectable stage III NSCLC patients. The survival benefit is even greater when combined with chemotherapy. The main mechanism of the survival benefit may be the improvement of anti-tumor immune function.

Objective:To compare the positioning errors in tracing the body surface markers between radiotherapy placement with or without using the laser positioning coordination system in post-breast conservative surgery patients, and to verify the clinical value of the laser positioning coordination system.Methods:A total of 45 post-breast-conservative surgery patients who underwent radiotherapy in Department of Radiation Oncology of the Affiliated Hospital of Inner Mongolia Medical University from January 2022 to September 2023 were prospectively collected. In the experimental group 1 ( n=15), the initial version of the laser positioning coordination system was employed to trace the body surface markers. In the experimental group 2 ( n=15), the upgraded version of the laser positioning coordination system was adopted to draw the body surface markers. In the control group ( n=15), the body surface markers were traced with conventional approach. All patients were treated with spiral tomotherapy (TOMO), and the error values in the left and right directions ( X), head and foot directions ( Y), ventral and dorsal directions ( Z), and rotation angles (ROLL) before each radiotherapy were recorded. The differences in the positioning errors among the three groups were analyzed by t-test. Results:The positioning errors in the X, Y, Z directions and ROLL in the experimental group 1 were (3.10±2.43) mm, (4.36±3.45) mm, (2.29±2.49) mm and 0.95°±0.88°, and (2.88±2.28) mm, (3.58±2.95) mm, (2.40±2.54) mm, and 0.70°±0.70° in the experimental group 2, and (4.32±3.48) mm, (5.49±4.74) mm, (2.61±3.38) mm and 1.22°±1.16° in the control group, respectively. Statistical significance was observed in the differences of positioning errors in the X, Y directions and ROLL between the experimental group 1 and control group ( t=4.32, 2.89, 2.78, P < 0.001, =0.004, =0.006), respectively. Statistical significance was detected in the differences of positioning errors in the X, Y directions and ROLL between the experimental group 2 and control group ( t=5.20, 5.14, 5.82, all P<0.001). Statistical significance was noted in the differences of positioning errors in the Y direction and ROLL between the experimental group 1 and 2 ( t=2.58, 3.41, P=0.010, 0.001). Conclusion:The laser positioning coordination system-assisted tracing the body surface marking line can significantly reduce the positioning errors in the X and Y directions and ROLL, and the upgraded version of the laser positioning coordination system can further reduce the positioning errors in the Y direction and ROLL compared with the initial version, which is of high clinical application value.

Objective:To explore the occurrence of immune-related adverse events (irAEs) and the relationship to efficacy of camrelizumab in treatment for patients with non-small cell lung cancer (NSCLC).Methods:Clinical data of patients with NSCLC who received camrelizumab in at the Affiliated Hospital of Inner Mongolia Medical University from December 2020 to December 2022 were collected, and the efficacy of camrelizumab and the occurrence of irAEs were retrospectively analyzed. Patients were divided into irAEs group and non-irAEs group according to whether they developed irAEs. The objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS) of the 2 groups were compared.Results:A total of 48 patients were entered in the analysis, including 41 males (85.4%) and 7 females (14.6%), with an age of (65.9±7.4) years; the median treatment cycle was 9 (6, 14); the overall ORR was 52.1% (25/48), the DCR was 83.3% (40/48), and the median PFS was 11 months. Among the 48 patients, 34 patients (70.8%) had 59 times of irAEs, of which 8 patients (16.7%) had at least one irAE of grade ≥3. The median time of irAEs occurrence was 5 (3, 7) treatment cycles. The irAEs with an incidence of >10% included reactive cutaneous capillary endothelial proliferation (RCCEP), thyroid injury, skin injury, lung injury, liver injury, and blood toxicity, with the incidences of 37.5% (18/48), 18.8 (9/48), 16.7% (8/48), 12.5% (6/48), 10.4% (5/48), and 10.4% (5/48), respectively. Compared with non-irAEs group, patients in the irAEs group had higher ORR and DCR [64.7% (22/34) vs. 3/14, 91.2% (31/34) vs. 9/14] and longer median PFS (12.0 months vs. 7.0 months, hazard ratio=0.418, 95% confidence interval: 0.193-0.905), and the differences were statistically significant (all P<0.05). Conclusions:The common irAEs of camrelizumab in treatment for patients with NSCLC was RCCEP, and fewer serious irAEs occurs. To a certain extent, patients who experience irAEs during camrelizumab treatment may predict a more pronounced therapeutic response.

Objective:To explore the occurrence of immune-related adverse events (irAEs) and the relationship to efficacy of camrelizumab in treatment for patients with non-small cell lung cancer (NSCLC).Methods:Clinical data of patients with NSCLC who received camrelizumab in at the Affiliated Hospital of Inner Mongolia Medical University from December 2020 to December 2022 were collected, and the efficacy of camrelizumab and the occurrence of irAEs were retrospectively analyzed. Patients were divided into irAEs group and non-irAEs group according to whether they developed irAEs. The objective response rate (ORR), disease control rate (DCR), and progression-free survival (PFS) of the 2 groups were compared.Results:A total of 48 patients were entered in the analysis, including 41 males (85.4%) and 7 females (14.6%), with an age of (65.9±7.4) years; the median treatment cycle was 9 (6, 14); the overall ORR was 52.1% (25/48), the DCR was 83.3% (40/48), and the median PFS was 11 months. Among the 48 patients, 34 patients (70.8%) had 59 times of irAEs, of which 8 patients (16.7%) had at least one irAE of grade ≥3. The median time of irAEs occurrence was 5 (3, 7) treatment cycles. The irAEs with an incidence of >10% included reactive cutaneous capillary endothelial proliferation (RCCEP), thyroid injury, skin injury, lung injury, liver injury, and blood toxicity, with the incidences of 37.5% (18/48), 18.8 (9/48), 16.7% (8/48), 12.5% (6/48), 10.4% (5/48), and 10.4% (5/48), respectively. Compared with non-irAEs group, patients in the irAEs group had higher ORR and DCR [64.7% (22/34) vs. 3/14, 91.2% (31/34) vs. 9/14] and longer median PFS (12.0 months vs. 7.0 months, hazard ratio=0.418, 95% confidence interval: 0.193-0.905), and the differences were statistically significant (all P<0.05). Conclusions:The common irAEs of camrelizumab in treatment for patients with NSCLC was RCCEP, and fewer serious irAEs occurs. To a certain extent, patients who experience irAEs during camrelizumab treatment may predict a more pronounced therapeutic response.