and all stage IIIC patients. Stage IIIA includes conditions such as T4N0M0, T3N1M0, T4N1M0, T1N2M0 and T2N2M0, stage IIIB includes conditions such as T3N2M0, T4N2M0, T1N3M0 and T2N3M0, and stage IIIC includes conditions such as T3N3M0 and T4N3M0. ①Inapplicable stage III patients include: some patients with T4 and T3, or patients with poor lung function that cannot tolerate surgery; some patients with stage IIIB of N2 who cannot receive surgical treatment, which includes multistation lymph node metastasis or fixed multistation N2 lymph node metastasis (lymph nodes with short diameter >2 cm on CT scan map); patients with stage IIIB and IIIC of N3. (ii) In the past 30 years, the treatment of stage III inoperable NSCLC has progressed slowly, with standard treatment recommended only for concurrent radiotherapy, and treatment efficacy has reached a bottleneck, with a median survival of approximately 20.3 to 28.7 months. (iii) The exploratory results of the PACIFIC study demonstrated for the first time that the addition of immune consolidation therapy after concurrent radiotherapy significantly improved the survival of patients with unresectable stage III NSCLC. PACIFIC is a placebo-controlled, multicenter, randomized, double-blind phase III clinical study. Patients enrolled in the study were inoperable, stage III NSCLC patients with stable disease after receiving radical concurrent radiotherapy, grouped in a 2:1 ratio. The experimental group received dulvalizumab, 10 mg/kg once every 2 weeks for up to 1 year, and the control group received placebo. Progression-free survival was significantly better in the dulvalizumab consolidation group than in the placebo group after concurrent radiotherapy (median PFS 17.2 months vs. 5.6 months, HR=0.52, P<0.001), with a full 3-fold increase in progression-free survival. Median survival was 47.5 months, compared with 29.1 months in the placebo group, an extension of 18.4 months and a 29% reduction in the risk of death (HR=0.71; 95% CI: 0.57 to 0.88). 1-year survival was 83.1% vs 66.3%, 2-year survival was 75.3% vs 55.6%, 3-year survival was 57% vs. 43.5%, 4-year survival rate was 49.6% vs. 36.3%, and 5-year survival rate was 42.9% vs. 33.4%, respectively. ④ Due to the high toxicity of concurrent radiotherapy, many patients are unable to tolerate it. Only 60%-70% of patients in Europe and the United States are able to receive simultaneous radiotherapy. In China, more than 70% of hospitals still use sequential radiotherapy, and sequential radiotherapy can be used as an alternative treatment option for those who cannot tolerate synchronous radiotherapy. ⑤ GEMSTONE-301 is a randomized, double-blind, placebo-controlled phase III study designed to evaluate the efficacy and safety of sugilizumab as consolidation therapy in patients with unresectable stage III NSCLC who have not experienced disease progression after synchronous or sequential radiotherapy. Median PFS was 9.0 and 5.8 months in the sugilizumab and placebo groups, respectively, as assessed by a blinded independent central review committee (BICR), with sugilizumab significantly reducing the risk of disease progression or death by 36% (HR 0.64, 95% CI 0.48-0.85, P=0.0026); 12-month PFS rates were 45% in the sugilizumab and placebo groups vs. 26% and 18-month PFS rates of 39% vs. 23%. Patients showed clinical benefit after either synchronous or sequential radiotherapy. The median PFS was 10.5 months vs 6.4 months in the sugilizumab and placebo groups (HR=0.66) for patients who received synchronous radiotherapy before the trial and 8.1 months vs 4.1 months in both groups (HR=0.59) for patients who received sequential radiotherapy before the trial. (6) For stage III inoperable NSCLC, there are studies such as EORTC08941, INT0139, and ESPANTUE that investigated the efficacy of surgery versus radiotherapy after neoadjuvant therapy, all of which confirmed that surgery was not significantly better than radiotherapy, at least for this group of patients who required total pneumonectomy, and that surgery was not beneficial. This is despite studies, including neoadjuvant studies such as CheckMate-816, confirming a pathologic complete remission (pCR) rate of 24% in the group receiving preoperative nabulizumab in combination with chemotherapy, compared with only 2.2% in the chemotherapy alone group (OR=13.94, 99% CI 3.49 to 55.75, p<0.0001). Subgroup analysis showed that nabolutumab combined with chemotherapy improved pCR regardless of patient disease stage, histologic type, tumor mutational load (TMB) and PD-L1 expression level. pCR reached 33% in patients receiving radiotherapy in ESPANTUE, however, and large clinical studies are needed to further explore neoadjuvant therapy with chemotherapy combined with immunotherapy in stage III inoperable NSCLC. (7) For patients with N3, regardless of the results achieved with neoadjuvant therapy, there is currently no evidence that neoadjuvant therapy can be followed by surgery, and the standard treatment modality for such patients is concurrent radiotherapy. ⑧ The 5-year survival rate for stage III NSCLC reported by the International Association for the Study of Lung Cancer in 2017 was 41% for stage IIIA, 24% for stage IIIB, and 12% for stage IIIC. The 5-year recurrence rate for patients with operable stage III NSCLC was 76%. And the results of the PACIFIC study showed that the 3-year survival rate was 57% and the 5-year survival rate was 42.9% when receiving this treatment modality. The time to recurrence and survival of lung cancer after surgery are closely related to several aspects, including whether the surgery is standardized, whether the staging is standardized, whether the postoperative treatment is standardized, the general condition of the patient, the type of postoperative pathology, the degree of differentiation and genetic status.