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目的:对晚期非小细胞肺癌(NSCLC)应用免疫检查点抑制剂PD-1前是否放疗进行总结，阐明放疗对PD-1应用的疗效及肺不良反应。方法:回顾性分析2015—2019年间河南省肿瘤医院接受免疫治疗的Ⅳ期NSCLC患者资料，收集患者基本信息、放疗及免疫治疗情况以及肺部不良反应情况。根据PD-1抑制剂应用前是否接受放疗分为既往放疗组和未放疗组，应用n Kaplan-n Meier法生存分析。n 结果:共纳入患者90例，其中既往放疗组39例，未放疗组51例。中位随访时间22.9个月，既往放疗组与未放疗组中位无进展生存期为7.5个月(95%n CI为5.4～9.5个月)与4.1个月(95%n CI为3.1～5.1个月)(n P＝0.003)，中位总生存期为15.2个月(95%n CI为12.3～18.1个月)与9.3个月(95%n CI为6.1～12.5个月(n P＝0.040)。肺不良反应两组相近(n P＝0.154)。n 结论:Ⅳ期NSCLC患者中PD-1抑制剂治疗前接受放疗患者无进展生存及总生存较未行放疗患者明显获益，肺不良反应亦未增加，但还需进一步扩大样本研究。“,”Objective:To investigate whether radiotherapy should be delivered before the application of immune checkpoint inhibitor PD-1 in patients with advanced non-small cell lung cancer (NSCLC) and evaluate the effect of previous radiotherapy on the efficacy and pulmonary toxicity of PD-1 inhibitor.Methods:Clinical data of patients with stage Ⅳ NSCLC who received immunotherapy in Henan Cancer Hospital from March 2015 to September 2019 were retrospectively analyzed. The baseline data of patients, the status of radiotherapy and immunotherapy and the pulmonary toxicity were collected. According to whether radiotherapy was given before PD-1 inhibitor application, all patients were divided into the previous radiotherapy and non-radiotherapy groups. Survival analysis was performed by n Kaplan-n Meier method.n Results:A total of 90 patients were enrolled including 39 cases in the previous radiotherapy group and 51 cases in the non-radiotherapy group. The median follow-up time was 22.9 months. The median progression-free survival (mPFS) in the previous radiotherapy group was 7.5 months (95%n CI 5.4-9.5 months), significantly longer compared with 4.1 months (95%n CI 3.1-5.1 months) in the non-radiotherapy group (n P=0.003). The median overall survival (mOS) significantly differed between two groups[15.2 months (95%n CI 12.3-18.1 months) n vs. 9.3 months (95%n CI 6.1-12.5 months)](n P=0.040). The incidence of pulmonary toxicity showed no significant difference between two groups (n P=0.154).n Conclusions:Patients with stage Ⅳ NSCLC patients in the previous radiotherapy group obtain significantly better mPFS and mOS and similar pulmonary toxicity compared with their counterparts in the non-radiotherapy group. Nevertheless, the findings remain to be validated by subsequent investigations with larger sample size.