{
  "abstract": "Real-world data with more than 10 years of follow-up among Chinese patients with unresectable locally advanced squamous cell lung cancer (SqCLC) treated with definitive chemoradiotherapy are scarce. This single-center cohort with complete 14-year longitudinal surveillance was constructed to map long-term survival kinetics, screen independent prognostic markers, and depict full disease trajectories, so as to facilitate stratified surveillance and personalized therapeutic management. This retrospective single-center real-world cohort enrolled 260 stage IIIA-IIIC unresectable SqCLC patients receiving definitive chemoradiotherapy between 2012-2019. Kaplan-Meier curves were used to estimate overall survival (OS), first progression-free survival (PFS1), and post-salvage second progression-free survival (PFS2); the log-rank test was applied for inter-group comparison. Multivariable Cox proportional-hazards regression (enter method) was utilized to screen independent prognostic factors, and a clinically-oriented 12-month PFS1 cutoff was used for risk stratification. With maximum follow-up exceeding 14 years (data cut-off June 1, 2026), the 10-year OS rate was 35.0%. The survival curve exhibited a distinct three-phase trajectory: a high-risk phase during the first 3 years accounting for approximately half of all events, a decelerating decline from year 3 to 10, and a stable plateau beyond 10 years, with OS rates at 10 and 14 years both approximating 35%. Multivariable analysis identified age <65 years, peripherally located tumors, absence of radiation pneumonitis, objective response to first-line therapy, and PFS1 ≥12 months as independent protective factors for OS, among which PFS1 ≥12 months yielded the strongest effect [hazard ratio (HR) =2.70, P<0.001]. First disease progression occurred in 86.0% of patients, of whom 32.0% presented with oligometastatic lesions (defined as ≤5 metastatic lesions confined to limited anatomic sites without widespread disseminated disease); those receiving active local salvage therapy achieved a 14-year PFS2 rate of 48.0%. An interval of ≤3 months from diagnosis to radiotherapy initiation was associated with a significantly higher objective response rate (ORR) compared with >3 months (73.0% vs. 57.0%, P<0.05). A 10-year survival rate of 35% is achievable in patients with locally advanced unresectable SqCLC after definitive chemoradiotherapy, with substantially reduced risks of recurrence and all-cause mortality beyond the 10-year landmark. A PFS1 ≥12 months serves as a simple and robust prognostic biomarker for long-term survival, and active local salvage of oligometastatic lesions enables durable disease control. Surveillance schedules and consolidation strategies may be tailored according to patients' progression-free status at 12 months.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University & Hebei Clinical Research Center for Radiation Oncology, Shijiazhuang, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Zhongfei Jia",
      "orcid": "0000-0001-7030-9503"
    },
    {
      "affs": [
        0
      ],
      "name": "Jingchen Huo",
      "orcid": "0009-0005-8589-1950"
    },
    {
      "affs": [
        0
      ],
      "name": "Jie Yang",
      "orcid": "0009-0009-6079-8521"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/c0bcz1gbpxcx1.bib",
  "cited_by": 0,
  "doi": "10.21037/jtd-2026-2234",
  "fulltext_url": "https://europepmc.org/articles/PMC13740700",
  "id": "c0bcz1gbpxcx1",
  "issns": [
    "2072-1439",
    "2077-6624"
  ],
  "landing_url": "https://europepmc.org/article/MED/42996892",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Lung Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7134197080",
  "pdf_url": "https://europepmc.org/articles/PMC13740700?pdf=render",
  "pmcid": "PMC13740700",
  "pmid": "42996892",
  "published": "2026-09-30",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/c0bcz1gbpxcx1.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42996892",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42996892"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Lung Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Long-term survival patterns and prognostic stratification in patients with unresectable locally advanced squamous cell lung cancer receiving definitive chemoradiotherapy: a 14-year single-center real-world cohort.",
  "title_text": "Long-term survival patterns and prognostic stratification in patients with unresectable locally advanced squamous cell lung cancer receiving definitive chemoradiotherapy: a 14-year single-center real-world cohort.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/c0bcz1gbpxcx1",
  "venue": "Journal of thoracic disease",
  "versions": []
}