The Efficacy and Safety of Brain Radiotherapy Combined With Immune Checkpoint Inhibitors (ICIs) for Small-Cell Lung Cancer (SCLC) Patients With Brain Metastases (BMs).

IF 2.3 3区医学 Q3 ONCOLOGY

Thoracic Cancer Pub Date : 2025-06-01 DOI:10.1111/1759-7714.70112

Jie Xu, Yanling Yang, Tingting Chen, Dongmin Liu, Yajing Yuan, Liming Xu

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Abstract

Objective: This study was designed to evaluate the efficacy and safety of brain radiotherapy combined with immune checkpoint inhibitors (ICIs) retrospectively in small-cell lung cancer (SCLC) patients with brain metastases (BMs).

Methods: A retrospective analysis was conducted on 42 SCLC patients with BMs, who received brain radiotherapy combined with ICIs at our Hospital from 2020 to 2024. They received chemotherapy plus ICIs regimens and brain radiotherapy, and received concurrent/sequential thoracic radiotherapy. This study investigated the forms of WBRT vs. WBRT+ simultaneous integrated boost (SIB, different doses of radiation being delivered simultaneously to different parts of the tumor) combined with ICIs on overall survival (OS), intracranial local control (iLC), and radiotherapy adverse reactions (side effection). The Kaplan-Meier method was used for survival rate analysis. The log-rank test was used to compare the survival curves between different groups, and the chi-square (χ²) test was used to compare categorical data.

Results: In all the patients, the median follow-up time was 19.2 (range: 9.79-36.8) months. The 2-year OS rate and iLC rate were 42.3% and 68.8%, respectively. A total of 26 patients died of disease progression; 2 patients developed radiation-induced brain necrosis. The results showed that there was no significant difference in radiation-induced brain necrosis between the two groups. The WBRT patients suffered high rates of headache, dizziness, nausea, and radiodermatitis. The 2-year OS and iLC were brilliant.

Conclusions: When brain radiotherapy combined with ICIs, even WBRT or WBRT + SIB had well OS and iLC with tolerable side reactions. Its indications needed to be considered from multiple perspectives. Further evaluation of brain radiotherapy combined with ICIs in SCLC BMs is required. Further prospective studies should be conducted to verify the conclusions.

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脑放疗联合免疫检查点抑制剂（ICIs）治疗小细胞肺癌（SCLC）脑转移（BMs）患者的疗效和安全性

目的：回顾性评价脑放疗联合免疫检查点抑制剂（ICIs）治疗小细胞肺癌（SCLC）脑转移（BMs）患者的疗效和安全性。方法：回顾性分析我院2020 - 2024年收治的42例脑转移性小细胞肺癌（SCLC）脑放疗联合ICIs患者。他们接受化疗+ ICIs方案和脑放疗，并接受同步/顺序胸部放疗。本研究探讨了WBRT与WBRT+同步综合增强（SIB，不同剂量的辐射同时传递到肿瘤的不同部位）联合ICIs的形式对总生存（OS）、颅内局部控制（iLC）和放疗不良反应（副作用）的影响。生存率分析采用Kaplan-Meier法。不同组间的生存曲线比较采用log-rank检验，分类资料比较采用χ2检验。结果：所有患者中位随访时间为19.2个月（范围：9.79 ~ 36.8）。2年OS率为42.3%，iLC率为68.8%。共有26例患者死于疾病进展；2例发生放射性脑坏死。结果显示，两组大鼠放射性脑坏死无显著性差异。WBRT患者头痛、头晕、恶心和放射性皮炎的发生率很高。2年的OS和iLC非常出色。结论：脑放疗联合ICIs时，即使WBRT或WBRT + SIB也有良好的OS和iLC，副反应可耐受。其迹象需要从多个角度加以考虑。需要进一步评估脑放疗联合ICIs治疗SCLC脑转移的效果。需要进一步的前瞻性研究来验证这些结论。

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来源期刊

Thoracic Cancer ONCOLOGY-RESPIRATORY SYSTEM

CiteScore

5.20

自引率

3.40%

发文量

439

审稿时长

2 months

期刊介绍： Thoracic Cancer aims to facilitate international collaboration and exchange of comprehensive and cutting-edge information on basic, translational, and applied clinical research in lung cancer, esophageal cancer, mediastinal cancer, breast cancer and other thoracic malignancies. Prevention, treatment and research relevant to Asia-Pacific is a focus area, but submissions from all regions are welcomed. The editors encourage contributions relevant to prevention, general thoracic surgery, medical oncology, radiology, radiation medicine, pathology, basic cancer research, as well as epidemiological and translational studies in thoracic cancer. Thoracic Cancer is the official publication of the Chinese Society of Lung Cancer, International Chinese Society of Thoracic Surgery and is endorsed by the Korean Association for the Study of Lung Cancer and the Hong Kong Cancer Therapy Society. The Journal publishes a range of article types including: Editorials, Invited Reviews, Mini Reviews, Original Articles, Clinical Guidelines, Technological Notes, Imaging in thoracic cancer, Meeting Reports, Case Reports, Letters to the Editor, Commentaries, and Brief Reports.