{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T09:58:58Z","timestamp":1766483938871,"version":"3.48.0"},"reference-count":29,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T00:00:00Z","timestamp":1765929600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the predictive value of the estimated dose of radiation to immune cells (EDRIC) with conventional dosimetric parameters for survival in elderly patients with stage III unresectable NSCLC after chemoimmunotherapy and radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective study of elderly patients (\u2265\u200965\u2009years) treated at two institutions. Patients were stratified by median EDRIC, mean lung dose (MLD), mean heart dose (MHD), and mean body dose (MBD). Survival was analyzed using Kaplan\u2013Meier, Cox regression, and ROC curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were well\u2010balanced across dosimetric parameter subgroups (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). The median progression\u2010free survival (PFS) and overall survival (OS) for the entire cohort were 23.9\u2009months and 46.0\u2009months, respectively. EDRIC \u2265\u20096.4\u2009Gy was associated with worse PFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019) and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011), while MLD, MHD, and MBD showed no prognostic significance (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u20090.05). Multivariate analysis identified EDRIC \u2265\u20096.4\u2009Gy as an independent predictor of worse PFS (HR\u2009=\u20091.852,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) and OS (HR\u2009=\u20092.289,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048). Age\u2009\u2265\u200970\u2009years was also independently associated with poorer OS (HR\u2009=\u20092.870,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.011). ROC analysis demonstrated superior predictive performance of EDRIC over conventional parameters for 1\u2010, 2\u2010, and 3\u2010year PFS and OS, with particularly outstanding discrimination for 12\u2010month OS (AUC\u2009=\u20090.93).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>EDRIC shows potential in predicting survival for elderly stage III unresectable NSCLC patients, with 6.4\u2009Gy as a potential threshold for personalized radiotherapy optimization. These findings require prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1759-7714.70196","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T07:00:51Z","timestamp":1766041251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Value of the Estimated Dose of Radiation to Immune Cells Versus Conventional Parameters in Elderly Patients With Unresectable Stage III NSCLC: A Two\u2010Center Real\u2010World Study"],"prefix":"10.1111","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0263-515X","authenticated-orcid":false,"given":"Huan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Emergency, Beijing Chest Hospital Capital Medical University &amp; Beijing Tuberculosis and Thoracic Tumor Research Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xingyu","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Beijing Chest Hospital Capital Medical University &amp; Beijing Tuberculosis and Thoracic Tumor Research Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Song","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Beijing Chest Hospital Capital Medical University &amp; Beijing Tuberculosis and Thoracic Tumor Research Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Hebei PetroChina Central Hospital  Langfang Hebei China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Beijing Chest Hospital Capital Medical University &amp; Beijing Tuberculosis and Thoracic Tumor Research Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cuimeng","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Beijing Chest Hospital Capital Medical University &amp; Beijing Tuberculosis and Thoracic Tumor Research Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8808-9852","authenticated-orcid":false,"given":"Li","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Emergency, Beijing Chest Hospital Capital Medical University &amp; Beijing Tuberculosis and Thoracic Tumor Research Institute  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12051833"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.29245\/2578-2967\/2019\/1.1148"},{"issue":"5","key":"e_1_2_9_4_1","first-page":"375","article-title":"Non\u2010Small Cell Lung Cancer Therapy in the Elderly","volume":"9","author":"Gridelli C.","year":"2011","journal-title":"Clinical Advances in Hematology & Oncology"},{"issue":"5","key":"e_1_2_9_5_1","first-page":"367","article-title":"Current Status and Prospect of PD\u20101\/PD\u2010L1 Immune Checkpoint Inhibitor Therapy in Elderly Patients With Advanced NSCLC","volume":"27","author":"Mao Y.","year":"2024","journal-title":"Zhongguo Fei Ai Za 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Immunotherapy in Older Patients","volume":"23","author":"Marrone K.","year":"2017","journal-title":"Cancer Journal"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1348189"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13045-023-01426-4"},{"issue":"3","key":"e_1_2_9_27_1","first-page":"533","article-title":"Prognostic Factors in Elderly Patients With Advanced Non\u2010Small Cell Lung Cancer Treated With First\u2010Line Cisplatin\u2010Based Chemotherapy: A Retrospective Analysis of Single Institution","volume":"17","author":"Inal A.","year":"2012","journal-title":"Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.38.6.5457"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.32.0796"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/21514593221144179"}],"container-title":["Thoracic 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