肺癌脑转移患者颅放疗联合免疫治疗后脑损伤：一项回顾性研究。
Brain injury after cranial radiotherapy combined with immunotherapy for brain metastases in lung cancer: a retrospective study.
机构信息
Department of Radiation Oncology, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China.
Department of Radiology, Shandong Cancer Hospital & Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, Shandong Province, China.
出版信息
Future Oncol. 2023 Apr;19(13):947-959. doi: 10.2217/fon-2023-0207. Epub 2023 May 18.
To explore whether immune checkpoint inhibitors (ICIs) increase the incidence of radiation-induced brain injury in lung cancer patients with brain metastases. According to whether they received ICIs within 6 months before and after cranial radiotherapy (CRT), all patients were divided into two groups: ICIs + CRT group and CRT + non-ICIs group. The incidence of radiation necrosis (RN) in the CRT + ICIs group was 14.3%, while that in the CRT + non-ICIs group was 5.8% (p = 0.090). If ICIs were used within 3 months of CRT, there was statistical significance. A maximum diameter of brain metastasis >3.3 cm and cumulative radiation dose of metastatic lesions >75.7 Gy were risk factors for RN. ICIs could increase the risk of RN, especially when used within 3 months of CRT.
探讨免疫检查点抑制剂（ICI）是否会增加肺癌伴脑转移患者放射性脑损伤的发生率。根据患者在全脑放疗（CRT）前后 6 个月内是否接受 ICI，将所有患者分为两组：ICI+CRT 组和 CRT+非 ICI 组。ICI+CRT 组放射性坏死（RN）的发生率为 14.3%，而 CRT+非 ICI 组为 5.8%（p=0.090）。如果在 CRT 前 3 个月内使用 ICI，则具有统计学意义。脑转移瘤最大直径>3.3cm 和转移灶累积辐射剂量>75.7Gy 是 RN 的危险因素。ICI 可能会增加 RN 的风险，尤其是在 CRT 前 3 个月内使用时。
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