{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T09:13:41Z","timestamp":1783588421718,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate the prognostic value of the estimated dose of radiation to immune cells (EDRIC) and the radiotherapy-related nadir lymphocyte count (RT-NLC), and to establish a risk stratification model for predicting outcomes in patients with unresectable stage III non-small cell lung cancer (NSCLC) treated with definitive chemoradiotherapy (CRT) and immunotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 136 patients treated between May 2019 and November 2023. EDRIC and RT-NLC were dichotomized at median values. Survival analysis was performed using Kaplan\u2013Meier and Cox regression. High-risk patients were defined as having EDRIC \u2265 6.75 Gy and RT-NLC &amp;lt; 0.54\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      EDRIC inversely correlated with RT-NLC (r = \u20130.38,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). Lower EDRIC was associated with significantly improved median overall survival (OS: 49.7 vs. 38.1 months,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.015), progression-free survival (PFS: 29.7 vs. 17.3 months,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.006), locoregional relapse-free survival (LRFS: 32.4 vs. 19.8 months,\n                      <jats:italic>P<\/jats:italic>\n                      =\u00a00.004), and distant metastasis-free survival (DMFS: 44.8 vs. 24.0 months,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.001). On multivariable analysis, low EDRIC independently predicted improved OS (HR\u00a0=\u00a00.51), PFS (HR\u00a0=\u00a00.56), LRFS (HR\u00a0=\u00a00.53), and DMFS (HR\u00a0=\u00a00.42). High RT-NLC group was significantly prolonged median DMFS (44.8 vs 26.8 months,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.012). High-risk patients demonstrated inferior survival (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.05) but derived significant benefit from consolidation immunotherapy, with improved OS (HR\u00a0=\u00a00.37,\n                      <jats:italic>P<\/jats:italic>\n                      =\u00a00.041), PFS (HR\u00a0=\u00a00.44,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.034), and DMFS (HR\u00a0=\u00a00.33,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.011).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>EDRIC and RT-NLC are significant prognostic biomarkers in unresectable stage III NSCLC. A risk model integrating these parameters effectively identifies high-risk patients who obtain substantial survival benefit, particularly in distant metastasis control, from consolidation immunotherapy, supporting personalized treatment strategies. Prospective validation is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1734341","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T08:24:27Z","timestamp":1783585467000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk stratification model based on estimated dose of radiation to immune cells and radiotherapy-related nadir lymphocyte count for predicting the efficacy of consolidation immunotherapy in stage III non-small cell lung cancer"],"prefix":"10.3389","volume":"17","author":[{"given":"Wenlu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Radiotherapy, Shanxi Province Cancer Hospital\/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences\/Cancer Hospital Affiliated to Shanxi Medical University","place":["Taiyuan, 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