Intravenous itraconazole followed by oral itraconazole for the treatment of amphotericin-B-refractory invasive pulmonary aspergillosis.

OBJECTIVE

Patients with stage III non-small cell lung cancer (NSCLC) present with a heterogeneous disease profile and often require multifaceted treatment strategies. This research aimed to investigate the demographic features, therapeutic patterns, and survival outcomes of such patients in Vietnam.

METHODS

A retrospective descriptive study was conducted on 731 patients diagnosed with stage III NSCLC American Joint Committee on Cancer (AJCC) 8th edition, at Nghe An Oncology Hospital from January 2018 to August 2024. Descriptive statistics summarized baseline and treatment characteristics. We calculated progression-free survival (PFS) and overall survival (OS) through the Kaplan-Meier approach and compared survival curves with the log-rank test. Prognostic variables were assessed using Cox regression analysis.

RESULTS

Patients had a median age of 64 years, and the majority (84%) were male. Disease stages IIIA, IIIB, and IIIC accounted for 26.0%, 49.9%, and 24.1% of cases, respectively. Adenocarcinoma (60.7%) was the most common histological subtype. Initial treatments included surgery (8.5%), concurrent chemoradiotherapy (38.6%), sequential chemoradiotherapy (2.2%), radiotherapy alone (1.4%), systemic therapy (37.3%), and palliative care (12.0%). From 2018 to 2024, the use of systemic therapy declined (88.5% to 21.7%), while concurrent chemoradiotherapy rose significantly (1.1% to 51.5%). Median progression-free survival (mPFS) and median overall survival (mOS) were 8.9 months and 20.5 months, respectively. Patients with stage IIIA had significantly better outcomes (mPFS: 12.6 months; mOS: 32.4 months; p < 0.001). Surgical treatment yielded the longest survival (mPFS: 13.5 months; mOS: 42.8 months). Favorable prognostic factors included adenocarcinoma subtype, presence of driver mutations, stage IIIA, and good performance status.

CONCLUSION

For stage III NSCLC, concurrent chemoradiotherapy is still considered the standard treatment, whereas surgery can provide the highest survival advantage in carefully selected cases. Histology, molecular profile, and disease stage are key prognostic indicators.