Durvalumab consolidation after chemoradiotherapy for stage III non-small cell lung cancer (NSCLC) has become the standard of care. Single-center results were examined for treatment outcomes and patterns of pneumonitis in clinical practice. Patients with stage III NSCLC who underwent chemoradiotherapy at our institution (n = 150) were included. The patients were treated with chemoradiotherapy and durvalumab consolidation (Group D, n = 69) or chemoradiotherapy alone (Group N, n = 81). The overall survival (OS), progression-free survival (PFS), and the incidence of and risk factors for 12-month pneumonitis grade ≥ 2 (G2) were investigated. Two-year OS rates were 71.6% in Group D and 52.7% in Group N (p= 0.052). Two-year PFS rates were 43.0% in Group D and 26.5% in Group N (p= 0.010), although a propensity score matched analysis showed no significant difference. The incidence of 12-month pneumonitis ≥ G2 tended to be higher in Group D than in Group N (41.9% vs. 26.3%,p= 0.080). However, there was no difference in pneumonitis ≥ G3 rates (10.5% vs. 12.6%,p= 0.657). A multivariate analysis showed that the lung volume spared from 5 Gy (VS5) < 1800 cm3was a risk factor for pneumonitis ≥ G2 in Group D. Durvalumab consolidation showed the potential to prolong PFS without increasing the severity of pneumonitis.
对于III期非小细胞肺癌（NSCLC）患者，放化疗后使用度伐利尤单抗巩固治疗已成为标准治疗方案。本研究旨在评估临床实践中该方案的治疗效果及肺炎发生模式。研究纳入在本机构接受放化疗的III期NSCLC患者（n=150），其中69例接受放化疗联合度伐利尤单抗巩固治疗（D组），81例仅接受放化疗（N组）。研究主要观察总生存期（OS）、无进展生存期（PFS）以及12个月内≥2级（G2）肺炎的发生率与危险因素。结果显示：D组与N组的2年OS率分别为71.6%和52.7%（p=0.052）；2年PFS率分别为43.0%和26.5%（p=0.010），但经倾向评分匹配分析后未见显著差异。D组12个月内≥G2肺炎的发生率有高于N组的趋势（41.9% vs. 26.3%，p=0.080），但≥G3肺炎发生率无显著差异（10.5% vs. 12.6%，p=0.657）。多因素分析显示，在D组中，受照剂量<5Gy的肺体积（VS5）<1800 cm³是发生≥G2肺炎的危险因素。研究表明，度伐利尤单抗巩固治疗具有延长PFS的潜力，且未增加重度肺炎的发生风险。
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