Propensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatment

Abstract This study evaluated the efficacy and safety of combining high-dose-rate brachytherapy, immune checkpoint inhibitors, and docetaxel as second-line treatment for advanced NSCLC, given the poor prognosis after first-line therapy. We conducted a single-center, retrospective, propensity score-m...

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Main Authors: Ran Cui, Hong Su, Yan Jiang, Xinlin Yu, Yu Liu
Format: Article
Language:English
Published: Nature Portfolio 2025-04-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-97918-z
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author Ran Cui
Hong Su
Yan Jiang
Xinlin Yu
Yu Liu
author_facet Ran Cui
Hong Su
Yan Jiang
Xinlin Yu
Yu Liu
author_sort Ran Cui
collection DOAJ
description Abstract This study evaluated the efficacy and safety of combining high-dose-rate brachytherapy, immune checkpoint inhibitors, and docetaxel as second-line treatment for advanced NSCLC, given the poor prognosis after first-line therapy. We conducted a single-center, retrospective, propensity score-matched study comparing HDR brachytherapy plus ICIs and docetaxel (study group) versus ICIs plus docetaxel (control group) in patients with advanced NSCLC who progressed after prior treatment without known driver gene mutations or uninvestigated mutation status. After propensity score matching, 21 patients were included in each group. The study group had a higher ORR (42.9% vs. 28.6%). Median OS was 18.6 months for the study group and 12.8 months for the control group (HR 0.45, 95% CI 0.20–0.85, P = 0.042). Median PFS was 8.6 vs. 5.6 months (HR   0.29, 95% CI 0.15–0.55, P < 0.001). The DCR was higher in the study group (71.4% vs. 61.9%). Treatment-related AEs were manageable, with no significant increase in grade 3/4 toxicities in the study group. Results suggest that combining high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel may improve survival and response rates in advanced NSCLC after first-line therapy. Prospective randomized trials are necessary to confirm these findings and validate the strategy’s effectiveness.
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spelling doaj-art-ffa7a9b4134245d0b0dd5a7aa771b88e2025-08-20T02:17:09ZengNature PortfolioScientific Reports2045-23222025-04-0115111310.1038/s41598-025-97918-zPropensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatmentRan Cui0Hong Su1Yan Jiang2Xinlin Yu3Yu Liu4Department of Oncology, The First People’s Hospital of NeijiangDepartment of Oncology, The First People’s Hospital of NeijiangDepartment of Gastroenterology, The People’s Hospital of LongchangDepartment of Oncology, The First People’s Hospital of NeijiangDepartment of Oncology, The First People’s Hospital of NeijiangAbstract This study evaluated the efficacy and safety of combining high-dose-rate brachytherapy, immune checkpoint inhibitors, and docetaxel as second-line treatment for advanced NSCLC, given the poor prognosis after first-line therapy. We conducted a single-center, retrospective, propensity score-matched study comparing HDR brachytherapy plus ICIs and docetaxel (study group) versus ICIs plus docetaxel (control group) in patients with advanced NSCLC who progressed after prior treatment without known driver gene mutations or uninvestigated mutation status. After propensity score matching, 21 patients were included in each group. The study group had a higher ORR (42.9% vs. 28.6%). Median OS was 18.6 months for the study group and 12.8 months for the control group (HR 0.45, 95% CI 0.20–0.85, P = 0.042). Median PFS was 8.6 vs. 5.6 months (HR   0.29, 95% CI 0.15–0.55, P < 0.001). The DCR was higher in the study group (71.4% vs. 61.9%). Treatment-related AEs were manageable, with no significant increase in grade 3/4 toxicities in the study group. Results suggest that combining high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel may improve survival and response rates in advanced NSCLC after first-line therapy. Prospective randomized trials are necessary to confirm these findings and validate the strategy’s effectiveness.https://doi.org/10.1038/s41598-025-97918-zNon-small cell lung cancerHigh-dose-rate brachytherapyImmune checkpoint inhibitorsPropensity score matchingTreatment-related adverse events
spellingShingle Ran Cui
Hong Su
Yan Jiang
Xinlin Yu
Yu Liu
Propensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatment
Scientific Reports
Non-small cell lung cancer
High-dose-rate brachytherapy
Immune checkpoint inhibitors
Propensity score matching
Treatment-related adverse events
title Propensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatment
title_full Propensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatment
title_fullStr Propensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatment
title_full_unstemmed Propensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatment
title_short Propensity score analysis of high-dose rate brachytherapy, immune checkpoint inhibitors, and docetaxel in second-line advanced NSCLC treatment
title_sort propensity score analysis of high dose rate brachytherapy immune checkpoint inhibitors and docetaxel in second line advanced nsclc treatment
topic Non-small cell lung cancer
High-dose-rate brachytherapy
Immune checkpoint inhibitors
Propensity score matching
Treatment-related adverse events
url https://doi.org/10.1038/s41598-025-97918-z
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