Department of Radiation Oncology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, Japan.
Department of Dermatology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, Japan.
Jpn J Radiol. 2018 Dec;36(12):712-718. doi: 10.1007/s11604-018-0774-8. Epub 2018 Sep 11.
We retrospectively evaluated the tumor regression after radiotherapy in combination with the immune checkpoint inhibitor nivolumab for metastatic melanoma.
We evaluated the extracranial metastatic melanoma lesions to which concomitant radiotherapy with nivolumab was administered from June 2015 to February 2017. Tumor volume and maximum diameter were measured at the time of pre-radiotherapy and best response, and the tumor reduction rate was assessed in two ways that our hospital adopts: tumor volume and diameter.
Seven lesions in five patients were evaluated. The median time from the start of nivolumab treatment to the start of radiotherapy was 5 months (range 0-22 months). The objective response rate was 85.7% in the evaluation by tumor volume and 42.9% by maximum diameter of the tumor. The objective complete response rate was 28.6% in evaluation by tumor volume and 14.3% by maximum dia. The 1-year tumor control rate was 62.5%. The 1- and 2-year overall survival rate after nivolumab treatment were 75% and 50%, respectively. Two patients who obtained a complete response had presented with vitiligo.
The combination of radiotherapy and nivolumab treatment produced favorable responses. Vitiligo may be correlated with a good response to concomitant radiotherapy with nivolumab.
我们回顾性评估了转移性黑色素瘤患者接受放疗联合免疫检查点抑制剂纳武单抗治疗后的肿瘤消退情况。
我们评估了 2015 年 6 月至 2017 年 2 月期间接受纳武单抗同步放疗的颅外转移性黑色素瘤病变。在放疗前和最佳反应时测量肿瘤体积和最大直径，并采用我院采用的两种方法评估肿瘤缩小率：肿瘤体积和直径。
5 名患者的 7 个病灶被评估。从纳武单抗治疗开始到放疗开始的中位时间为 5 个月（范围 0-22 个月）。肿瘤体积评估的客观缓解率为 85.7%，肿瘤最大直径评估的客观缓解率为 42.9%。肿瘤体积评估的客观完全缓解率为 28.6%，肿瘤最大直径评估的客观完全缓解率为 14.3%。1 年肿瘤控制率为 62.5%。纳武单抗治疗后 1 年和 2 年的总生存率分别为 75%和 50%。2 名获得完全缓解的患者出现了白癜风。
放疗联合纳武单抗治疗产生了良好的反应。白癜风可能与纳武单抗同步放疗的良好反应相关。
