{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:44:36Z","timestamp":1790934276064,"version":"4.1.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T00:00:00Z","timestamp":1760572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Radiat Oncol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Real-world data on patients with locally advanced non-small cell lung cancer (LA-NSCLC) treated with chemoradiotherapy have been reported; however, prognostic factors in patients with negative or low programmed cell death ligand 1 (PD-L1) expression are unclear. Therefore, we aimed to explore prognostic factors in patients with LA-NSCLC with negative or low PD-L1 expression using real-world data obtained after the PACIFIC trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with LA-NSCLC with negative or low PD-L1 expression who received definitive radiotherapy at our institution between March 2017 and May 2022 were included. Competing risk analyses were used to evaluate cumulative incidence of cancer-specific death (CI-CSD), cumulative incidence of recurrence (CI-R), cumulative incidence of distant metastasis (CI-DM), and cumulative incidence of in-field recurrence (CI-IFR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included the data of 130 patients. Median follow-up was 37 (range, 2\u201372) months after radiotherapy initiation; 54 (41.5%) patients died, among whom 49 died of lung cancer, and 75 (57.7%) received durvalumab. Multivariate analyses revealed that interstitial lung abnormality (ILA) score\u2009\u2265\u20091 was a significant factor of shorter OS and higher CI-IFR, and a mean heart dose\u2009\u2265\u20097.5\u00a0Gy showed a trend toward significance for shorter OS., Internal high-dose volumetric modulated arc therapy was associated with lower CI-R, whereas poor baseline performance status correlated with higher CI-DM. Notably, durvalumab administration was marginally associated with lower CI-R.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pre-treatment ILA and high mean heart doses negatively impacted OS in patients with LA-NSCLC with negative or low PD-L1 expression according to real-world data obtained after the PACIFIC trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13014-025-02733-5","type":"journal-article","created":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T03:37:39Z","timestamp":1760585859000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Locally advanced non-small cell lung cancer with negative or low programmed death ligand 1 expression: a prognostic factor analysis of real-world data after the PACIFIC trial"],"prefix":"10.1186","volume":"20","author":[{"given":"Tairo","family":"Kashihara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kae","family":"Okuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Nagao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kana","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoya","family":"Kaneda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko","family":"Kubo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimiteru","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Yatabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Kusumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Ohe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Igaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,16]]},"reference":[{"key":"2733_CR1","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1056\/NEJMoa1709937","volume":"377","author":"SJ Antonia","year":"2017","unstructured":"Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer. N Engl J Med. 2017;377:1919\u201329. https:\/\/doi.org\/10.1056\/NEJMoa1709937.","journal-title":"N Engl J Med"},{"key":"2733_CR2","doi-asserted-by":"publisher","first-page":"2342","DOI":"10.1056\/NEJMoa1809697","volume":"379","author":"SJ Antonia","year":"2018","unstructured":"Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med. 2018;379:2342\u201350. https:\/\/doi.org\/10.1056\/NEJMoa1809697.","journal-title":"N Engl J Med"},{"key":"2733_CR3","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.jtho.2019.10.002","volume":"15","author":"JE Gray","year":"2020","unstructured":"Gray JE, Villegas A, Daniel D, Vicente D, Murakami S, Hui R, et al. Three-year overall survival with durvalumab after chemoradiotherapy in stage III NSCLC-Update from PACIFIC. J Thorac Oncol. 2020;15:288\u201393. https:\/\/doi.org\/10.1016\/j.jtho.2019.10.002.","journal-title":"J Thorac Oncol"},{"key":"2733_CR4","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1200\/JCO.21.01308","volume":"40","author":"DR Spigel","year":"2022","unstructured":"Spigel DR, Faivre-Finn C, Gray JE, Vicente D, Planchard D, Paz-Ares L, et al. Five-year survival outcomes from the PACIFIC trial: durvalumab after chemoradiotherapy in stage III non-small-cell lung cancer. J Clin Oncol. 2022;40:1301\u201311. https:\/\/doi.org\/10.1200\/JCO.21.01308.","journal-title":"J Clin Oncol"},{"key":"2733_CR5","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.ejca.2020.10.008","volume":"142","author":"A Desilets","year":"2021","unstructured":"Desilets A, Blanc-Durand F, Lau S, Hakozaki T, Kitadai R, Malo J, et al. Durvalumab therapy following chemoradiation compared with a historical cohort treated with chemoradiation alone in patients with stage III non-small cell lung cancer: A real-world multicentre study. Eur J Cancer. 2021;142:83\u201391. https:\/\/doi.org\/10.1016\/j.ejca.2020.10.008.","journal-title":"Eur J Cancer"},{"key":"2733_CR6","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1111\/1759-7714.14452","volume":"13","author":"A Saad","year":"2022","unstructured":"Saad A, Goldstein J, Appel S, Daher S, Urban D, Onn A, et al. Chemoradiation followed by adjuvant durvalumab in stage III non-small cell lung cancer: Real-world comparison of treatment outcomes to historical controls treated with chemoradiation alone. Thorac Cancer. 2022;13:1763\u201371. https:\/\/doi.org\/10.1111\/1759-7714.14452.","journal-title":"Thorac Cancer"},{"key":"2733_CR7","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1016\/j.ijrobp.2021.12.150","volume":"112","author":"Y Wang","year":"2022","unstructured":"Wang Y, Zhang T, Huang Y, Li W, Zhao J, Yang Y, et al. Real-world safety and efficacy of consolidation durvalumab after chemoradiation therapy for stage III non-small cell lung cancer: A systematic review and meta-analysis. Int J Radiat Oncol Biol Phys. 2022;112:1154\u201364. https:\/\/doi.org\/10.1016\/j.ijrobp.2021.12.150.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2733_CR8","doi-asserted-by":"publisher","first-page":"e2224478","DOI":"10.1001\/jamanetworkopen.2022.24478","volume":"5","author":"MD Pichert","year":"2022","unstructured":"Pichert MD, Canavan ME, Maduka RC, Li AX, Ermer T, Zhan PL, et al. Immunotherapy after chemotherapy and radiation for clinical stage III lung cancer. JAMA Netw Open. 2022;5:e2224478. https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.24478.","journal-title":"JAMA Netw Open"},{"key":"2733_CR9","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.lungcan.2020.10.006","volume":"150","author":"M Faehling","year":"2020","unstructured":"Faehling M, Schumann C, Christopoulos P, Hoffknecht P, Alt J, Horn M, et al. Durvalumab after definitive chemoradiotherapy in locally advanced unresectable non-small cell lung cancer (NSCLC): Real-world data on survival and safety from the German expanded-access program (EAP). Lung Cancer. 2020;150:114\u201322. https:\/\/doi.org\/10.1016\/j.lungcan.2020.10.006.","journal-title":"Lung Cancer"},{"key":"2733_CR10","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/j.ijrobp.2022.03.015","volume":"113","author":"AK Bryant","year":"2022","unstructured":"Bryant AK, Sankar K, Strohbehn GW, Zhao L, Daniel V, Elliott D, et al. Prognostic and predictive role of PD-L1 expression in stage III non-small cell lung cancer treated with definitive chemoradiation and adjuvant durvalumab. Int J Radiat Oncol Biol Phys. 2022;113:752\u20138. https:\/\/doi.org\/10.1016\/j.ijrobp.2022.03.015.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2733_CR11","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1016\/j.annonc.2020.03.287","volume":"31","author":"L Paz-Ares","year":"2020","unstructured":"Paz-Ares L, Spira A, Raben D, Planchard D, Cho BC, \u00d6zg\u00fcro\u011flu M, et al. Outcomes with durvalumab by tumour PD-L1 expression in unresectable, stage III non-small-cell lung cancer in the PACIFIC trial. Ann Oncol. 2020;31:798\u2013806. https:\/\/doi.org\/10.1016\/j.annonc.2020.03.287.","journal-title":"Ann Oncol"},{"key":"2733_CR12","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.jtho.2016.09.134","volume":"12","author":"CK Speirs","year":"2017","unstructured":"Speirs CK, DeWees TA, Rehman S, Molotievschi A, Velez MA, Mullen D, et al. Heart dose is an independent dosimetric predictor of overall survival in locally advanced non-small cell lung cancer. J Thorac Oncol. 2017;12:293\u2013301. https:\/\/doi.org\/10.1016\/j.jtho.2016.09.134.","journal-title":"J Thorac Oncol"},{"key":"2733_CR13","doi-asserted-by":"publisher","first-page":"109454","DOI":"10.1016\/j.radonc.2022.109454","volume":"180","author":"T Kashihara","year":"2023","unstructured":"Kashihara T, Nakayama Y, Okuma K, Takahashi A, Kaneda T, Katagiri M, et al. Impact of interstitial lung abnormality on survival after adjuvant durvalumab with chemoradiotherapy for locally advanced non-small cell lung cancer. Radiother Oncol. 2023;180:109454. https:\/\/doi.org\/10.1016\/j.radonc.2022.109454.","journal-title":"Radiother Oncol"},{"key":"2733_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.radonc.2018.02.023","volume":"127","author":"U Nestle","year":"2018","unstructured":"Nestle U, De Ruysscher D, Ricardi U, Geets X, Belderbos J, P\u00f6ttgen C, et al. ESTRO ACROP guidelines for target volume definition in the treatment of locally advanced non-small cell lung cancer. Radiother Oncol. 2018;127:1\u20135. https:\/\/doi.org\/10.1016\/j.radonc.2018.02.023.","journal-title":"Radiother Oncol"},{"key":"2733_CR15","doi-asserted-by":"publisher","first-page":"651409","DOI":"10.3389\/fonc.2021.651409","volume":"11","author":"T Kashihara","year":"2021","unstructured":"Kashihara T, Nakamura S, Murakami N, Ito K, Matsumoto Y, Kobayashi K, et al. Initial experience of intentional internal high-dose policy volumetric modulated Arc therapy of neck lymph node metastases\u2009\u2265\u20092\u00a0cm in patients with head and neck squamous cell carcinoma. Front Oncol. 2021;11:651409. https:\/\/doi.org\/10.3389\/fonc.2021.651409.","journal-title":"Front Oncol"},{"key":"2733_CR16","doi-asserted-by":"publisher","first-page":"e20860","DOI":"10.1097\/MD.0000000000020860","volume":"99","author":"T Kashihara","year":"2020","unstructured":"Kashihara T, Kobayashi K, Iijima K, Murakami N, Yoshida K, Okuma K, et al. A case report of a patient with bulky uterine cervical neoplasm who achieved complete response with intentional internal high-dose policy high-dose-rate interstitial brachytherapy. Med (Baltim). 2020;99:e20860. https:\/\/doi.org\/10.1097\/MD.0000000000020860.","journal-title":"Med (Baltim)"},{"key":"2733_CR17","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/bmt.2012.244","volume":"48","author":"Y Kanda","year":"2013","unstructured":"Kanda Y. Investigation of the freely available easy-to-use software \u2018EZR\u2019 for medical statistics. Bone Marrow Transpl. 2013;48:452\u20138. https:\/\/doi.org\/10.1038\/bmt.2012.244.","journal-title":"Bone Marrow Transpl"},{"key":"2733_CR18","doi-asserted-by":"publisher","first-page":"100606","DOI":"10.1016\/j.adro.2020.10.019","volume":"6","author":"T Kashihara","year":"2021","unstructured":"Kashihara T, Nakayama Y, Ito K, Kubo Y, Okuma K, Shima S, et al. Usefulness of simple original interstitial lung abnormality scores for predicting radiation pneumonitis requiring steroidal treatment after definitive radiation therapy for patients with locally advanced non-small cell lung cancer. Adv Radiat Oncol. 2021;6:100606. https:\/\/doi.org\/10.1016\/j.adro.2020.10.019.","journal-title":"Adv Radiat Oncol"},{"key":"2733_CR19","doi-asserted-by":"publisher","first-page":"2872","DOI":"10.1200\/JCO.2018.79.0006","volume":"36","author":"KC Arbour","year":"2018","unstructured":"Arbour KC, Mezquita L, Long N, Rizvi H, Auclin E, Ni A, et al. Impact of baseline steroids on efficacy of programmed cell death-1 and programmed death-ligand 1 Blockade in patients with non-small-cell lung cancer. J Clin Oncol. 2018;36:2872\u20138. https:\/\/doi.org\/10.1200\/JCO.2018.79.0006.","journal-title":"J Clin Oncol"},{"key":"2733_CR20","doi-asserted-by":"publisher","first-page":"e000477","DOI":"10.1136\/esmoopen-2018-000477","volume":"4","author":"CM Della Corte","year":"2019","unstructured":"Della Corte CM, Morgillo F. Early use of steroids affects immune cells and impairs immunotherapy efficacy. ESMO Open. 2019;4:e000477. https:\/\/doi.org\/10.1136\/esmoopen-2018-000477.","journal-title":"ESMO Open"},{"key":"2733_CR21","doi-asserted-by":"publisher","first-page":"2701","DOI":"10.1084\/jem.20190738","volume":"216","author":"A Tokunaga","year":"2019","unstructured":"Tokunaga A, Sugiyama D, Maeda Y, Warner AB, Panageas KS, Ito S, et al. Selective Inhibition of low-affinity memory CD8\u2009+\u2009T cells by corticosteroids. J Exp Med. 2019;216:2701\u201313. https:\/\/doi.org\/10.1084\/jem.20190738.","journal-title":"J Exp Med"},{"issue":"31","key":"2733_CR22","doi-asserted-by":"publisher","first-page":"3713","DOI":"10.1200\/JCO.24.00191","volume":"42","author":"RJ Verheijden","year":"2024","unstructured":"Verheijden RJ, de Groot JS, Fabriek BO, Hew MN, May AM, Suijkerbuijk KPM. Corticosteroids for Immune-Related adverse events and checkpoint inhibitor efficacy: analysis of six clinical trials. J Clin Oncol. 2024;42(31):3713\u201324. https:\/\/doi.org\/10.1200\/JCO.24.00191.","journal-title":"J Clin Oncol"},{"key":"2733_CR23","doi-asserted-by":"publisher","first-page":"2128","DOI":"10.7150\/ijbs.35460","volume":"15","author":"H Wang","year":"2019","unstructured":"Wang H, Wei J, Zheng Q, Meng L, Xin Y, Yin X, et al. Radiation-induced heart disease: a review of classification, mechanism and prevention. Int J Biol Sci. 2019;15:2128\u201338. https:\/\/doi.org\/10.7150\/ijbs.35460.","journal-title":"Int J Biol Sci"},{"key":"2733_CR24","doi-asserted-by":"publisher","first-page":"495","DOI":"10.1016\/j.radonc.2016.04.025","volume":"119","author":"SL Tucker","year":"2016","unstructured":"Tucker SL, Liu A, Gomez D, Tang LL, Allen P, Yang J, et al. Impact of heart and lung dose on early survival in patients with non-small cell lung cancer treated with chemoradiation. Radiother Oncol. 2016;119:495\u2013500. https:\/\/doi.org\/10.1016\/j.radonc.2016.04.025.","journal-title":"Radiother Oncol"},{"key":"2733_CR25","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1056\/NEJMoa1209825","volume":"368","author":"SC Darby","year":"2013","unstructured":"Darby SC, Ewertz M, McGale P, Bennet AM, Blom-Goldman U, Br\u00f8nnum D, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013;368:987\u201398. https:\/\/doi.org\/10.1056\/NEJMoa1209825.","journal-title":"N Engl J Med"},{"key":"2733_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.lungcan.2020.05.004","volume":"146","author":"F Sun","year":"2020","unstructured":"Sun F, Franks K, Murray L, Lilley J, Wheller B, Banfill K, et al. Cardiovascular mortality and morbidity following radical radiotherapy for lung cancer: is cardiovascular death under-reported. Lung Cancer. 2020;146:1\u20135. https:\/\/doi.org\/10.1016\/j.lungcan.2020.05.004.","journal-title":"Lung Cancer"},{"key":"2733_CR27","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.radonc.2018.05.017","volume":"128","author":"JA Contreras","year":"2018","unstructured":"Contreras JA, Lin AJ, Weiner A, Speirs C, Samson P, Mullen D, et al. Cardiac dose is associated with immunosuppression and poor survival in locally advanced non-small cell lung cancer. Radiother Oncol. 2018;128:498\u2013504. https:\/\/doi.org\/10.1016\/j.radonc.2018.05.017.","journal-title":"Radiother Oncol"},{"key":"2733_CR28","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1016\/j.radonc.2021.01.034","volume":"157","author":"R Upadhyay","year":"2021","unstructured":"Upadhyay R, Venkatesulu BP, Giridhar P, Kim BK, Sharma A, Elghazawy H, et al. Risk and impact of radiation related lymphopenia in lung cancer: A systematic review and meta-analysis. Radiother Oncol. 2021;157:225\u201333. https:\/\/doi.org\/10.1016\/j.radonc.2021.01.034.","journal-title":"Radiother Oncol"},{"key":"2733_CR29","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1016\/j.radonc.2022.10.019","volume":"177","author":"B Venkatesulu","year":"2022","unstructured":"Venkatesulu B, Giridhar P, Pujari L, Chou B, Lee JH, Block AM, et al. Lymphocyte sparing normal tissue effects in the clinic (LymphoTEC): A systematic review of dose constraint considerations to mitigate radiation-related lymphopenia in the era of immunotherapy. Radiother Oncol. 2022;177:81\u201394. https:\/\/doi.org\/10.1016\/j.radonc.2022.10.019.","journal-title":"Radiother Oncol"},{"key":"2733_CR30","doi-asserted-by":"publisher","unstructured":"Lu S, Kato T, Dong X, Ahn MJ, Quang LV, Soparattanapaisarn N, et al. Osimertinib after chemoradiotherapy in stage III EGFR-Mutated NSCLC. N Engl J Med. 2024 Jun 2. https:\/\/doi.org\/10.1056\/NEJMoa2402614.","DOI":"10.1056\/NEJMoa2402614"},{"key":"2733_CR31","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/S1470-2045(14)71207-0","volume":"16","author":"JD Bradley","year":"2015","unstructured":"Bradley JD, Paulus R, Komaki R, Masters G, Blumenschein G, Schild S, et al. Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus Paclitaxel with or without cetuximab for patients with stage IIIA or IIIB non-small-cell lung cancer (RTOG 0617): a randomised, two-by-two factorial phase 3 study. Lancet Oncol. 2015;16:187\u201399. https:\/\/doi.org\/10.1016\/S1470-2045(14)71207-0.","journal-title":"Lancet Oncol"},{"key":"2733_CR32","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1200\/JCO.19.01162","volume":"38","author":"JD Bradley","year":"2020","unstructured":"Bradley JD, Hu C, Komaki RR, Masters GA, Blumenschein GR, Schild SE, et al. Long-term results of NRG oncology RTOG 0617: Standard- versus high-dose chemoradiotherapy with or without cetuximab for unresectable stage III non-small-cell lung cancer. J Clin Oncol. 2020;38:706\u201314. https:\/\/doi.org\/10.1200\/JCO.19.01162.","journal-title":"J Clin Oncol"},{"key":"2733_CR33","doi-asserted-by":"publisher","first-page":"109688","DOI":"10.1016\/j.radonc.2023.109688","volume":"185","author":"F Arcidiacono","year":"2023","unstructured":"Arcidiacono F, Anselmo P, Casale M, Trippa F. 18F-FDG-PET guided vs whole tumour radiotherapy dose escalation in patients with locally advanced non-small cell lung cancer (PET-Boost): results from a randomised clinical trial: should dose intensification be discontinued or should accelerated schemes remain an important area of clinical research. Radiother Oncol. 2023;185:109688. https:\/\/doi.org\/10.1016\/j.radonc.2023.109688.","journal-title":"Radiother Oncol"},{"key":"2733_CR34","doi-asserted-by":"publisher","first-page":"180","DOI":"10.1016\/j.lungcan.2018.06.020","volume":"122","author":"A Hallqvist","year":"2018","unstructured":"Hallqvist A, Bergstr\u00f6m S, Bj\u00f6rkestrand H, Sv\u00e4rd AM, Ekman S, Lundin E, et al. Dose escalation to 84 Gy with concurrent chemotherapy in stage III NSCLC appears excessively toxic: results from a prematurely terminated randomized phase II trial. Lung Cancer. 2018;122:180\u20136. https:\/\/doi.org\/10.1016\/j.lungcan.2018.06.020.","journal-title":"Lung Cancer"},{"key":"2733_CR35","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1016\/j.ijrobp.2022.10.014","volume":"115","author":"YH Kim","year":"2023","unstructured":"Kim YH, Ahn SJ, Moon SH, Kim JH, Kim YC, Oh IJ, et al. Randomized, multicenter, phase 3 study of accelerated fraction radiation therapy with concomitant boost to the gross tumor volume compared with conventional fractionation in concurrent chemoradiation in patients with unresectable stage III non-small cell lung cancer: the Korean radiation oncology group 09\u2009\u2013\u200903 trial. Int J Radiat Oncol Biol Phys. 2023;115:873\u201385. https:\/\/doi.org\/10.1016\/j.ijrobp.2022.10.014.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2733_CR36","doi-asserted-by":"publisher","first-page":"934369","DOI":"10.3389\/fonc.2022.934369","volume":"12","author":"A Abravan","year":"2022","unstructured":"Abravan A, Price G, Banfill K, Marchant T, Craddock M, Wood J, et al. Role of real-world data in assessing cardiac toxicity after lung cancer radiotherapy. Front Oncol. 2022;12:934369. https:\/\/doi.org\/10.3389\/fonc.2022.934369.","journal-title":"Front Oncol"},{"key":"2733_CR37","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.radonc.2018.10.029","volume":"133","author":"J Xue","year":"2019","unstructured":"Xue J, Han C, Jackson A, Hu C, Yao H, Wang W, et al. Doses of radiation to the pericardium, instead of heart, are significant for survival in patients with non-small cell lung cancer. Radiother Oncol. 2019;133:213\u20139. https:\/\/doi.org\/10.1016\/j.radonc.2018.10.029.","journal-title":"Radiother Oncol"},{"key":"2733_CR38","doi-asserted-by":"publisher","first-page":"206","DOI":"10.1001\/jamaoncol.2020.6332","volume":"7","author":"KM Atkins","year":"2021","unstructured":"Atkins KM, Chaunzwa TL, Lamba N, Bitterman DS, Rawal B, Bredfeldt J, et al. Association of left anterior descending coronary artery radiation dose with major adverse cardiac events and mortality in patients with non-small cell lung cancer. JAMA Oncol. 2021;7:206\u201319. https:\/\/doi.org\/10.1001\/jamaoncol.2020.6332.","journal-title":"JAMA Oncol"}],"container-title":["Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13014-025-02733-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13014-025-02733-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13014-025-02733-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:24:44Z","timestamp":1781612684000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13014-025-02733-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,16]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2733"],"URL":"https:\/\/doi.org\/10.1186\/s13014-025-02733-5","relation":{},"ISSN":["1748-717X"],"issn-type":[{"value":"1748-717X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,16]]},"assertion":[{"value":"10 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 September 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All analyses performed in this study were approved by the Institutional Review Board of the National Cancer Center (approval number: 2017-091) and were conducted in accordance with the ethical standards of the committee and the 1964 Helsinki Declaration and its later amendments. Informed consent was not required because the data used in this study comprised anonymised information, and active refusal of participation was available as an option. Furthermore, information about the study plan was posted on the website of our institution.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"155"}}