Liu Xue-Jie, Ge Heng, Yuan Chun-Luan
Department of Oncology, The First People's Hospital of Lianyungang, Lianyungang 222016, Jiangsu Province, China.
Department of Oncology, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450001, Henan Province, China.
World J Clin Oncol. 2025 Aug 24;16(8):107009. doi: 10.5306/wjco.v16.i8.107009.
The optimal sequencing of immune checkpoint inhibitor (ICI) and brain radiotherapy in the management of brain metastasis from non-small cell lung cancer (NSCLC) is unclear.
To evaluate the survival of concurrent ICI and consolidation ICI in NSCLC patients treated with brain radiotherapy.
We retrospectively analyzed NSCLC patients treated with brain radiotherapy and ICI. Treatment response and survival were estimated. The cox proportional hazards regression model was utilized to investigate the association between overall survival and clinical variables.
There were 54 patients in concurrent ICI and radiotherapy group, and 62 individuals treated with radiotherapy followed by consolidation ICI. The objective response rates were similar between the two group. The median progression free survival was significantly high in the concurrent ICI group compared with consolidation ICI group (9.56 months 8.15 months, = 0.038). In addition, the median overall survival was 22.08 months in the concurrent ICI group, clearly longer than that in the consolidation group (13.24 months, = 0.009).
In NSCLC patients with brain metastases, our analyses suggested that radiotherapy concurrent with ICI was associated with significant benefit compared with radiotherapy followed by consolidation ICI.
在非小细胞肺癌（NSCLC）脑转移的治疗中，免疫检查点抑制剂（ICI）与脑放疗的最佳顺序尚不清楚。
评估接受脑放疗的NSCLC患者同步ICI和巩固性ICI治疗后的生存率。
我们回顾性分析了接受脑放疗和ICI治疗的NSCLC患者。评估治疗反应和生存率。采用Cox比例风险回归模型研究总生存期与临床变量之间的关联。
同步ICI和放疗组有54例患者，放疗后巩固性ICI组有62例患者。两组的客观缓解率相似。同步ICI组的中位无进展生存期显著高于巩固性ICI组（9.56个月对8.15个月，P = 0.038）。此外，同步ICI组的中位总生存期为22.08个月，明显长于巩固性ICI组（13.24个月，P = 0.009）。
在NSCLC脑转移患者中，我们的分析表明，与放疗后巩固性ICI相比，同步放疗与ICI治疗有显著益处。
