Department of Oncology, Shandong Cancer Hospital and Institute Affiliated to Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China.
Tianjin Medical University, Tianjin, 300060, China.
J Cancer Res Clin Oncol. 2023 May;149(5):1825-1833. doi: 10.1007/s00432-022-04121-y. Epub 2022 Jun 23.
The objective of this study was to evaluate the safety and efficacy of immune checkpoint inhibitors in small cell lung cancer patients with brain metastases.
We retrospectively reviewed the records of small cell lung cancer patients with brain metastases treated with chemotherapy and radiotherapy for brain metastases with or without immune checkpoint inhibitors at our institution from January 2019 to January 2021. Patients were divided into two groups. In Group A, patients received chemotherapy and radiotherapy for brain metastases. In Group B, patients received chemotherapy, radiotherapy for brain metastases and at least four cycles of immunotherapy. Overall survival and intracranial progression-free survival were assessed using Kaplan-Meier estimates and Cox regression models.
A total of 282 patients were enrolled in our study. At the end of the study (May 12, 2021), the median overall survival was 13.3 months among 218 patients in Group A and 33.4 months among 64 patients in Group B (hazards ratio [HR] 0.320, 95% confidence interval [CI], 0.189-0.545, P < 0.001). Both univariate and multivariate analyses suggested that two factors were significantly correlated with overall survival: the inclusion of immunotherapy in the regimen and the presence of extracranial metastases. The median intracranial progression-free survival was 6.93 months in Group A and 10.73 months in Group B (HR = 0.540, 95% CI, 0.346-0.841, P = 0.006). The intracranial objective response rate of Group B was greater than that of Group A, but the intracranial disease control rate was similar between the groups.
Immunotherapy plus chemotherapy and radiotherapy for brain metastases showed promising efficacy for small cell lung cancer patients with brain metastases.
本研究旨在评估免疫检查点抑制剂在小细胞肺癌伴脑转移患者中的安全性和疗效。
我们回顾性分析了 2019 年 1 月至 2021 年 1 月在我院接受化疗和放疗治疗脑转移的小细胞肺癌患者的病历，这些患者的脑转移灶接受了或未接受免疫检查点抑制剂治疗。患者分为两组，A 组接受化疗和放疗治疗脑转移，B 组接受化疗、放疗治疗脑转移和至少四个周期的免疫治疗。采用 Kaplan-Meier 估计和 Cox 回归模型评估总生存期和颅内无进展生存期。
本研究共纳入 282 例患者。研究结束时（2021 年 5 月 12 日），A 组 218 例患者的中位总生存期为 13.3 个月，B 组 64 例患者的中位总生存期为 33.4 个月（风险比[HR]0.320，95%置信区间[CI]0.189-0.545，P<0.001）。单因素和多因素分析均表明，有两个因素与总生存期显著相关：方案中包含免疫治疗和存在颅外转移。A 组的中位颅内无进展生存期为 6.93 个月，B 组为 10.73 个月（HR=0.540，95%CI0.346-0.841，P=0.006）。B 组的颅内客观缓解率大于 A 组，但两组的颅内疾病控制率相似。
免疫治疗联合化疗和放疗治疗脑转移对小细胞肺癌伴脑转移患者具有良好的疗效。
