■全脑放疗(WBRT)仍然是治疗源自非小细胞肺癌(NSCLC)患者的脑转移(BMs)的基本方式,抗PD-1治疗已证明这些患者的颅内反应。我们旨在评估两种治疗的组合是否可以产生累加功效。
■对我们机构的数据库进行回顾性审查,以确定在2015年至2020年期间接受抗PD1治疗和/或WBRT治疗的患有BM的NSCLC患者。患者特征,主要成果,包括无进展生存期(PFS)和总生存期(OS),并分析了影响这些结局的因素。采用SPSS24进行统计分析。根据数据类型采用适当的统计检验。
■总的来说,确定了21例接受WBRT的NSCLCBM患者。其中,10例在WBRT开始后30天内接受了抗PD1治疗.单独使用WBRT的中位PFS为3个月(95%CI0.8-5.1),而联合治疗为11个月(95%CI6.3-15.6)。联合方法的疾病进展风险降低了71%(HR0.29,95%CI0.11-0.80;p=0.016)。联合方法也观察到OS改善的趋势(HR0.33,95%CI0.08-1.12;p=0.107)。同时治疗(p=0.028)和男性(p=0.052)与改善的PFS相关,而OS仅与年龄相关(p=0.02)。
■同时应用WBRT和抗PD1治疗可延缓EGFR和ALK阴性NSCLC组织学确诊的BM患者的进展并提高生存率。有必要进行前瞻性研究以验证和阐明两种模式的累加效应。
UNASSIGNED: Whole-brain radiotherapy (WBRT) remains an essential modality of treatment for brain metastases (BMs) derived from non-small cell lung cancer (NSCLC) patients and anti-PD-1 therapy has demonstrated intracranial responses in these patients. We aimed to evaluate if the combination of the two treatments could yield additive efficacy.
UNASSIGNED: A retrospective review of our institution\'s database was carried out to identify NSCLC patients with BMs who had been treated with anti-PD1 therapy and/or WBRT between 2015 and 2020. Patient characteristics, main outcomes, including progression-free survival (PFS) and overall survival (OS), and factors affecting these outcomes were analyzed. SPSS 24 was used for statistical analysis. Appropriate statistical tests were employed according to the type of data.
UNASSIGNED: Overall, 21 NSCLC BM patients were identified that had received WBRT. Of these, ten had been additionally treated with anti-PD1 therapy within 30 days of WBRT initiation. Median PFS was 3 (95% CI 0.8-5.1) months with WBRT alone versus 11 (95% CI 6.3-15.6) months with combined treatment. Risk of disease progression was 71% lower with the combined approach (HR 0.29, 95% CI 0.11-0.80; p=0.016). A trend toward improved OS was also observed with the combined approach (HR 0.33, 95% CI 0.08-1.12; p=0.107). Concurrent treatment (p=0.028) and male sex (p=0.052) were associated with improved PFS, while OS was associated only with age (p=0.02).
UNASSIGNED: Concurrent WBRT and anti-PD1 therapy may delay progression and improve survival in BM patients with confirmed EGFR- and ALK-negative NSCLC histology. Prospective studies are warranted to validate and elucidate on the additive effect of the two modalities.