BACKGROUND AND PURPOSE: Real-world data on neoadjuvant therapy for stage I-III non-small cell lung cancer (NSCLC) is limited. This study evaluates the efficacy and safety of neoadjuvant chemotherapy alone versus chemotherapy combined with immunotherapy, focusing on pathological response, imaging outcomes, event-free survival (EFS), and adverse events. Additionally, a prognostic model for EFS is established. METHODS: Data from 134 NSCLC patients who received neoadjuvant therapy were analyzed. Pathological response rates, objective response rate(ORR), EFS and adverse events were compared between the two groups. Independent prognostic factors were identified using logistic and Cox regression analyses, and a predictive model was constructed and evaluated using nomograms, Receiver Operating Characteristic(ROC) curves, calibration curves, and Decision Curve Analysis(DCA) curves. RESULTS: 1.The chemotherapy combined with immunotherapy group showed higher Pathological Complete Response (pCR) (48.8% vs. 12.5%) and ORR (80.2% vs. 47.9%) compared to the chemotherapy group (P < 0.05), with no difference in Major Pathological Response(MPR) or R0 resection rates. 2. Chemotherapy combined with immunotherapy group did not significantly increase TRAEs or
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