A Multicenter Retrospective Study On The Prognosis Of Stage Ⅲ Unresectable Mutant Non-small Cell Lung Cancer With Tyrosine Kinase Inhibitors Therapy

Background: For unresectable stage III non-small cell lung cancer(NSCLC),concurrent chemoradiotherapy is the current standard treatment.Meanwhile,advanced NSCLC patients harboring driver-gene mutations can benefit from tyrosine kinase inhibitor(TKIs)therapy.In the real world,there is still room to explore the benefit of applying TKIs in stage III unresectable NSCLC patients with mutations..Methods: A total of 81 stage III unresectable mutant NSCLC patients from the Jinling Hospital and Jiangsu Cancer Hospital who received first-line application of TKIs were enrolled in this retrospective study.Authors followed up the included patients and calculated the data such as progression free survival(PFS)and overall survival(OS),as well as subsequent surgery,complications to evaluate the survival prognosis of the patients.Then,we explored whether TKIs with or without other treatments are beneficial for such patients,and what kind of patients benefit most from TKI monotherapy treatment or its combination.Results: The median survival was 41.47 months(95% confidence interval(CI):20.11–62.83),and the median progression-free survival of involved 81 patients was13.87 months(95% CI: 11.66–16.08).The 5-year survival rates were 91.0,80.3,56.1,45.5,and 32.5%,respectively.After first-line TKI therapy,seven patients(8.6%)were reevaluated as eligible for surgery and proceeded to surgery.Although no characteristics were finally found to be statistical prognostic,younger,female,non-smokers still tended to have a better prognosis with longer progression free survival and overall survival.Conclusion: Tyrosine kinase inhibitors are viable options for stage III unresectable mutant NSCLC patients and such patients derive good clinical benefit after first-line therapy.Patients with driver mutations who do not tolerate chemotherapy or radiotherapy,especially middle-aged adults,women as well as non-smoking patients,can select targeted therapy for first-line treatment.Meanwhile,such patients still have a chance of getting surgery after first-line treatment to prolong survival time.