脑转移瘤形成及立体定向放疗联合免疫治疗的放射效应：系统综述。
Brain metastasis formation and irradiation by stereotactic radiation therapy combined with immunotherapy: A systematic review.
机构信息
Institut Privé de Radiothérapie de Metz (IPRM), Hôpital-Clinique Claude Bernard, 97 Rue Claude Bernard, 57070 Metz, France.
Institut de Radiothérapie des Hautes Energies, Rue Lautréamont, 93000 Bobigny, France.
出版信息
Crit Rev Oncol Hematol. 2020 May;149:102923. doi: 10.1016/j.critrevonc.2020.102923. Epub 2020 Mar 3.
INTRODUCTION
Brain metastasis (BM) is a complex process that implies immune cells and microglia. Stereotactic radiation therapy (SRT) and immunotherapy (IT) are established to increase the immune response; but their association has never been prospectively studied.
MATERIALS AND METHODS
Two reviewers performed a systematic review in original papers published up to September 2019. We analysed OS, local (mLRF) and regional (mBRF) median disease-free survival in patients with BMs after SRT with and without IT.
RESULTS
Upon 14 studies, eleven concerned melanoma, three concerned lung cancers. SRT-IT showed better OS, mLRF and mBRF than SRT. mBRF was better if SRT was performed with short delay from IT. No higher rates of radionecrosis and haemorrhage were found among groups.
CONCLUSION
This review suggests SRT combined to IT in melanoma is safe and could provide better BRF, suggesting a lymphocytic immune reaction in brain. No improvement trend was found in lung cancer BM.
简介
脑转移（BM）是一个涉及免疫细胞和小胶质细胞的复杂过程。立体定向放射治疗（SRT）和免疫疗法（IT）已被确立为增强免疫反应的方法；但它们的联合应用从未被前瞻性研究过。
材料与方法
两位审查员对截至 2019 年 9 月发表的原始论文进行了系统评价。我们分析了接受 SRT 联合或不联合 IT 治疗的脑转移患者的总生存期（OS）、局部（mLRF）和区域（mBRF）无病中位生存时间。
结果
在 14 项研究中，有 11 项涉及黑色素瘤，3 项涉及肺癌。SRT-IT 比 SRT 具有更好的 OS、mLRF 和 mBRF。如果 SRT 与 IT 之间的延迟时间较短，则 mBRF 更好。各组之间未发现放射性坏死和出血的发生率更高。
结论
本综述表明，黑色素瘤的 SRT 联合 IT 是安全的，并可能提供更好的 BRF，提示脑内存在淋巴细胞免疫反应。在肺癌脑转移中未发现改善趋势。
Zotero 插件