Abstract：
BACKGROUND: Up to 30% patients newly diagnosed with advanced non-small cell lung cancer (NSCLC) present with brain metastases. In the absence of oncogenic addiction, first-line immunotherapy, alone or in combination with chemotherapy, is the current standard of care. This review aims to synthesize the available data regarding the efficacy of immunotherapy in these patients, and to discuss the possibility of its being coordinated with local treatments such as radiotherapy.
BACKGROUND: NSCLC patients with brain metastases appear to have survival benefits with immunotherapy similar to those of NSCLC patients without brain metastases. However, this finding is based on mainly prospective studies having included highly selected patients with pre-treated and stable brain metastases. Several retrospective studies and two prospective single-arm studies have confirmed the intracranial efficacy of immunotherapy, either alone or in combination with chemotherapy.
CONCLUSIONS: The indications and optimal timing for cerebral radiotherapy remain subjects of debate. To date, there exists no randomized study assessing the addition of brain radiotherapy to first-line immunotherapy. That said, a recent meta-analysis showed increased intracerebral response when radiotherapy complemented immunotherapy.
CONCLUSIONS: For NSCLC patients with brain metastases, the available data suggest a clear benefit of first-line immunotherapy, whether alone or combined with chemotherapy. However, most of these data are drawn from retrospective, non-randomized studies with small sample sizes.
BACKGROUND: NSCLC patients with brain metastases appear to have survival benefits with immunotherapy similar to those of NSCLC patients without brain metastases. However, this finding is based on mainly prospective studies having included highly selected patients with pre-treated and stable brain metastases. Several retrospective studies and two prospective single-arm studies have confirmed the intracranial efficacy of immunotherapy, either alone or in combination with chemotherapy.
CONCLUSIONS: The indications and optimal timing for cerebral radiotherapy remain subjects of debate. To date, there exists no randomized study assessing the addition of brain radiotherapy to first-line immunotherapy. That said, a recent meta-analysis showed increased intracerebral response when radiotherapy complemented immunotherapy.
CONCLUSIONS: For NSCLC patients with brain metastases, the available data suggest a clear benefit of first-line immunotherapy, whether alone or combined with chemotherapy. However, most of these data are drawn from retrospective, non-randomized studies with small sample sizes.
摘要：
背景：高达30%新诊断为晚期非小细胞肺癌（NSCLC）的患者存在脑转移。在没有致癌成瘾的情况下，一线免疫疗法,单独或与化疗联合使用，是目前的护理标准。这篇综述旨在综合有关这些患者的免疫治疗疗效的现有数据，并讨论其与放疗等局部治疗相协调的可能性。
背景：伴有脑转移的NSCLC患者与无脑转移的NSCLC患者的免疫疗法相似，具有生存益处。然而,这一发现主要基于前瞻性研究,这些研究包括经过高度筛选的治疗前和稳定的脑转移患者.几项回顾性研究和两项前瞻性单臂研究证实了免疫治疗的颅内疗效，单独或联合化疗。
结论：脑放疗的适应症和最佳时机仍是争论的话题。迄今为止,没有随机研究评估在一线免疫疗法中增加脑放疗.那就是说,最近的一项荟萃分析显示,放疗补充免疫治疗后,脑内反应增加.
结论：对于伴有脑转移的NSCLC患者，现有数据表明，一线免疫疗法具有明显的益处，无论是单独或联合化疗。然而,这些数据大部分来自回顾性研究，小样本量的非随机研究。
背景：伴有脑转移的NSCLC患者与无脑转移的NSCLC患者的免疫疗法相似，具有生存益处。然而,这一发现主要基于前瞻性研究,这些研究包括经过高度筛选的治疗前和稳定的脑转移患者.几项回顾性研究和两项前瞻性单臂研究证实了免疫治疗的颅内疗效，单独或联合化疗。
结论：脑放疗的适应症和最佳时机仍是争论的话题。迄今为止,没有随机研究评估在一线免疫疗法中增加脑放疗.那就是说,最近的一项荟萃分析显示,放疗补充免疫治疗后,脑内反应增加.
结论：对于伴有脑转移的NSCLC患者，现有数据表明，一线免疫疗法具有明显的益处，无论是单独或联合化疗。然而,这些数据大部分来自回顾性研究，小样本量的非随机研究。
