新辅助免疫化疗在可切除非小细胞肺癌（NSCLC）中具有良好的疗效。然而，在不可切除的IIIB期NSCLC患者中的作用仍存在争议。本研究旨在证明新辅助免疫化疗随后进行手术切除治疗初期不可切除的IIIB期NSCLC患者的疗效和安全性。本研究对2019年6月至2022年4月期间接受Pembrolizumab联合化疗的59例初期不可切除的IIIB期NSCLC患者进行了回顾性分析。收集和评估了临床特征、影像学和病理学反应以及生存结果。识别了59例初期不可切除的IIIB期NSCLC患者，并分为手术组（n=23）和非手术组（n=36），随访时间中位数为15.0个月。手术组的中位无进展生存期（PFS）/无疾病生存期（DFS）显著长于非手术组（未达到vs. 15.5个月，p=0.0031）。手术组和非手术组的中位总生存期（OS）均未达到，并且手术组的OS率为100％（23/23），非手术组为83.3％（30/36）。病理分析提示，23例患者中有13例（56.5％）达到了重要的病理学反应（MPR）或病理学完全缓解（pCR），与非MPR组相比，在MPR组中观察到更多的鳞状细胞癌病例（p=0.034）。手术组的所有患者均进行了R0切除，并且未记录到手术相关的死亡；只有3例患者（13.0％）经历了术后并发症。在这项回顾性研究中，新辅助免疫化疗后的手术切除对于初期不可切除的IIIB期NSCLC患者是有希望的，具有较高的MPR率和良好的手术安全性。版权所有©2023 Elsevier B.V. 发布。

Neoadjuvant immunochemotherapy is effective in resectable NSCLC. However, its role in unresectable stage IIIB NSCLC patients remains controversial. This study aimed to demonstrate the efficacy and safety of neoadjuvant immunochemotherapy followed by surgical resection to treat initial unresectable stage IIIB NSCLC patients.This study retrospectively analyzed 59 initial unresectable stage IIIB NSCLC patients who received induction pembrolizumab combined with chemotherapy between June 2019 and April 2022. Clinical characteristics, radiological and pathological responses, and survival outcomes were collected and evaluated.Fifity-nine initial unresectable stage IIIB NSCLC patients were identified and divided into surgery (n = 23) and non-surgery (n = 36) groups with a median follow-up time of 15.0 months. The median PFS/DFS of the surgery group was significantly longer than the non-surgery group (not reached vs. 15.5 months, p = 0.0031). The median overall survival (OS) was not reached in both groups, and the OS rate was 100% (23/23) in the surgery group and 83.3% (30/36) in the non-surgery group. The pathological analysis suggested that 13 of 23 patients (56.5%) achieved major pathological response (MPR) or pathological complete response (pCR), and more squamous cell carcinoma cases were observed in the MPR group compared to the non-MPR group (p = 0.034). All patients in the surgery group had an R0 resection, and no surgical-related mortality was recorded; only three patients (13.0%) experienced any postoperative complications.In this retrospective study, surgical resection after neoadjuvant immunochemotherapy was promising for initial unresectable stage IIIB NSCLC patients, with a high MPR rate and good surgical safety.Copyright © 2023. Published by Elsevier B.V.