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Abstract：
Whether cycle number influences the subsequent pathological or surgical outcomes remained unclear. This study aimed to assess the efficacy and surgical safety of neoadjuvant immunochemotherapy-based treatment in the real-world setting.
Clinical data of patients who received neoadjuvant immunochemotherapy for non-small-cell lung cancer between 2018 and 2021 were collected. Oncological outcomes such as objective response rate (ORR), major pathological response (MPR), and pathological complete response (pCR), and surgical outcomes including operating time, intraoperative bleeding, postoperative drainage, and hospital stay were analyzed.
In total, 176 patients were included, among whom 102 cases were lung squamous carcinoma (LUSQ). After immunochemotherapy, 98 (56%) of patients achieved ORR. Notably, the ORR (63% vs. 46%, p = 0.039) and pCR (45% vs. 27%, p = 0.022) were significantly higher in patients with LUSQ. For patients who received two, three, four, and five or more cycles, the ORRs were 52%, 67%, 53%, and 50% (p = 0.36). In post hoc analysis, cycle numbers showed no significant association with MPR or pCR (p = 0.14 and p = 0.073). Treatment cycles showed no influence on operating time, postoperative drainage, and hospital stay (p = 0.79, 0.37, and 0.22). Notably, the blood loss index of patients who received more than four cycles was higher than those receiving four or fewer cycles (mean blood loss: two or fewer cycles 153.1, three cycles 113.8, four cycles 137.6, and five or more cycles 293.3, respectively).
This study indicated that cycles of neoadjuvant immunochemotherapy had no significant effect on the feasibility and safety of surgery. Although not statistically significant, patients who received five or more cycles of treatment experienced higher intraoperative blood loss.
Clinical data of patients who received neoadjuvant immunochemotherapy for non-small-cell lung cancer between 2018 and 2021 were collected. Oncological outcomes such as objective response rate (ORR), major pathological response (MPR), and pathological complete response (pCR), and surgical outcomes including operating time, intraoperative bleeding, postoperative drainage, and hospital stay were analyzed.
In total, 176 patients were included, among whom 102 cases were lung squamous carcinoma (LUSQ). After immunochemotherapy, 98 (56%) of patients achieved ORR. Notably, the ORR (63% vs. 46%, p = 0.039) and pCR (45% vs. 27%, p = 0.022) were significantly higher in patients with LUSQ. For patients who received two, three, four, and five or more cycles, the ORRs were 52%, 67%, 53%, and 50% (p = 0.36). In post hoc analysis, cycle numbers showed no significant association with MPR or pCR (p = 0.14 and p = 0.073). Treatment cycles showed no influence on operating time, postoperative drainage, and hospital stay (p = 0.79, 0.37, and 0.22). Notably, the blood loss index of patients who received more than four cycles was higher than those receiving four or fewer cycles (mean blood loss: two or fewer cycles 153.1, three cycles 113.8, four cycles 137.6, and five or more cycles 293.3, respectively).
This study indicated that cycles of neoadjuvant immunochemotherapy had no significant effect on the feasibility and safety of surgery. Although not statistically significant, patients who received five or more cycles of treatment experienced higher intraoperative blood loss.
摘要：
目的：周期数是否影响随后的病理或手术结果仍不清楚。本研究旨在评估基于新辅助免疫化疗的治疗在现实世界中的疗效和手术安全性。
方法：收集2018年至2021年接受新辅助免疫化疗治疗非小细胞肺癌患者的临床资料。肿瘤学结果，如客观反应率(ORR)，主要病理反应（MPR），病理完全缓解（pCR），和手术结果，包括手术时间，术中出血,术后引流,并对住院时间进行分析。
结果：总计，包括176名患者，其中肺鳞癌(LUSQ)102例。免疫化疗后,98(56%)的患者取得ORR。值得注意的是,ORR(63%与46%,p=0.039）和pCR（45%与27%,p=0.022）在LUSQ患者中明显更高。对于接受两种治疗的患者，三,四,和五个或更多的周期，ORR为52%，67%,53%,和50%(p=0.36)。在事后分析中，周期数与MPR或pCR无显著相关性(p=0.14和p=0.073).治疗周期对手术时间没有影响，术后引流,住院时间（p=0.79、0.37和0.22）。值得注意的是,接受4个周期以上的患者的失血指数高于接受4个周期或更少周期的患者(平均失血量:2个周期或更少周期分别为153.1,3个周期113.8,4个周期137.6,5个周期或更多周期分别为293.3).
结论：本研究提示新辅助化疗周期对手术的可行性和安全性无明显影响。虽然没有统计学意义，接受5个周期或5个周期以上治疗的患者术中失血量较高.
方法：收集2018年至2021年接受新辅助免疫化疗治疗非小细胞肺癌患者的临床资料。肿瘤学结果，如客观反应率(ORR)，主要病理反应（MPR），病理完全缓解（pCR），和手术结果，包括手术时间，术中出血,术后引流,并对住院时间进行分析。
结果：总计，包括176名患者，其中肺鳞癌(LUSQ)102例。免疫化疗后,98(56%)的患者取得ORR。值得注意的是,ORR(63%与46%,p=0.039）和pCR（45%与27%,p=0.022）在LUSQ患者中明显更高。对于接受两种治疗的患者，三,四,和五个或更多的周期，ORR为52%，67%,53%,和50%(p=0.36)。在事后分析中，周期数与MPR或pCR无显著相关性(p=0.14和p=0.073).治疗周期对手术时间没有影响，术后引流,住院时间（p=0.79、0.37和0.22）。值得注意的是,接受4个周期以上的患者的失血指数高于接受4个周期或更少周期的患者(平均失血量:2个周期或更少周期分别为153.1,3个周期113.8,4个周期137.6,5个周期或更多周期分别为293.3).
结论：本研究提示新辅助化疗周期对手术的可行性和安全性无明显影响。虽然没有统计学意义，接受5个周期或5个周期以上治疗的患者术中失血量较高.
