Background: The purposes of this study were to evaluated the efficacy and changes in computed tomography (CT) imaging associated with tislelizumab combined with gemcitabine for advanced non-small cell lung cancer (NSCLC). Material and Methods: This study examined 122 patients with advanced NSCLC who were treated at our hospital between January 2021 and October 2023. Subjects were categorized into the control group (gemcitabine monotherapy) and study group (tislelizumab + gemcitabine), with 61 patients in each group. Clinical efficacy, CT imaging changes (maximum lesion diameter, CT value, short diameter of metastatic lymph nodes), serum tumor markers (CA125, CEA, NSE), quality of life (FACT-L), drug safety, and survival outcomes were compared between groups. Results: The study group showed higher rates of objective remission (42.62%) and clinical control (86.89%) compared to the control group (18.03% and 62.30%, respectively, x2=8.728, 9.731, P<0.05). CT parameters (maximum diameter, CT value, and short diameter of metastatic lymph nodes) were remarkably shorter in the study group (P<0.05). Serum CA125, CEA, and NSE levels were decreased in the study group, and their FACT-L score was higher (P<0.05). No remarkable discrepancy was found in complication rates. At the one-year follow-up, the survival rate was 70.49% in the study group and 44.26% in the control group (x2=13.571, P<0.05). Conclusion: Tislelizumab combined with gemcitabine improves short-term efficacy, reduces serum tumor markers, enhances life quality, increases survival rates in advanced NSCLC patients, and has a good safety profile.
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