Toxicity and time lapse between immunotherapy and stereotactic radiotherapy of brain metastases

被引：12

作者：

Cabanie, C. ^{[1
,7
,8
]}

Biau, J. ^{[1
,7
,8
]}

Durando, X. ^{[2
,7
,8
]}

Mansard, S. ^{[3
,7
,8
]}

Molnar, I ^{[4
,7
,8
]}

Chassin, V ^{[5
,7
,8
]}

Verrelle, P. ^{[1
,7
,8
]}

Khalil, T. ^{[6
,7
,8
]}

Lapeyre, M. ^{[1
,7
,8
]}

Dupic, G. ^{[1
]}

机构：

[1] Jean Perrin Ctr, Dept Radiat Oncol, 58 Rue Montalembert, F-63011 Clermont Ferrand, France

[2] Jean Perrin Ctr, Dept Med Oncol, 58 Rue Montalembert, F-63011 Clermont Ferrand, France

[3] Estaing Univ Hosp Ctr, Dept Dermatol, 1 Rue Lucie & Raymond Aubrac, F-63003 Clermont Ferrand, France

[4] Univ Clermont Auvergne, INSERM U1240 IMoST, F-63000 Clermont Ferrand, France

[5] Ctr Invest Clin UMR 501, F-63001 Clermont Ferrand, France

[6] Ctr Jean Perrin, Dept Clin Res Delegat Rech Clin & Innovat, F-63011 Clermont Ferrand, France

[7] Jean Perrin Ctr, Dept Med Phys, 58 Rue Montalembert, F-63011 Clermont Ferrand, France

[8] Gabriel Montpied Univ Hosp Ctr, Dept Neurosurg, 58 Rue Montalembert, F-63011 Clermont Ferrand, France

来源：

CANCER RADIOTHERAPIE | 2021年 / 25卷 / 05期

关键词：

Stereotactic radiotherapy; Immunotherapy; Brain metastases; Melanoma; Non-small-cell lung cancers; CELL LUNG-CANCER; RADIATION-THERAPY; OPEN-LABEL; RADIOSURGERY; MELANOMA; IPILIMUMAB; NIVOLUMAB; SURVIVAL; OUTCOMES; PEMBROLIZUMAB;

D O I：

10.1016/j.canrad.2021.01.007

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose. - Stereotactic radiotherapy (SRT) is the standard treatment for brain metastases of non-small-cell lung cancer (NSCLC) and melanoma, mostly in combination with immunotherapy. The objective was to retrospectively evaluate the influence of the time-lapse between immunotherapy and stereotactic radiotherapy on toxicity. Patients and methods. - From 2016 to 2019, 59 patients treated with SRT for 103 brain metastases of NSCLC (60%) and melanoma (40%) in combination with concomitant immunotherapy (<= 30 days) were included. The prescribed dose was 20 Gy/1f or 33 Gy/3f at the isocentre and 14 Gy or 23.1 Gy (70%) respectively at the PTV envelope (PTV = GTV + 2 mm). The mean tumour diameter was 14 mm (4-52 mm). The immunotherapies used were anti-PD1 and anti-PDL1 . The 103 metastases were classified into 3 groups according to the time-lapse between instatement of immunotherapy and instatement of SRT for the patient concerned: 7 (7%) in group A (<= 7 days), 38 (37%) in group B (7 to 14 days) and 58 (56%) in group C (14 to 30 days). Results. - The mean follow-up was 10.1 months. The median overall survival was 11.5 months for NSCLC and 12.5 months for melanoma. The percentage of local control (LC) at one year was 65.1% (93.6% for NSCLC and 26.5% for melanoma). The time-lapse between immunotherapy and SRT was not a significant predictor of LC (P = 0.86), while the histology was (P < 0.001). The proportion of grade >= 3 toxicities was 5.1%, and that of radionecrosis was 9.7% (among these patients, 80% were non-symptomatic): 0%, 13.1% and 8.6% for groups A, B and C respectively. The time-lapse between immunotherapy and SRT was not a significant predictor of toxicity. Only tumour volume was a significant predictive factor (P = 0.03). Conclusion. - The time lapse between immunotherapy and SRT does not influence brain toxicity. The tumour volume remains the main factor. (C) 2021 Published by Elsevier Masson SAS on behalf of Societe francaise de radiotherapie oncologique (SFRO).

引用

页码：432 / 440

页数：9

共 40 条

[1]

Acharya S, 2017, ADV RADIAT ONCOL, V2, P572, DOI 10.1016/j.adro.2017.07.003

[2] Clinical outcomes of melanoma brain metastases treated with stereotactic radiation and anti-PD-1 therapy [J].

Ahmed, K. A. ;

Stallworth, D. G. ;

Kim, Y. ;

Johnstone, P. A. S. ;

Harrison, L. B. ;

Caudell, J. J. ;

Yu, H. H. M. ;

Etame, A. B. ;

Weber, J. S. ;

Gibney, G. T. .

ANNALS OF ONCOLOGY, 2016, 27 (03) :434-441

[3] Outcomes targeting the PD-1/PD-L1 axis in conjunction with stereotactic radiation for patients with non-small cell lung cancer brain metastases [J].

Ahmed, Kamran A. ;

Kim, Sungjune ;

Arrington, John ;

Naghavi, Arash O. ;

Dilling, Thomas J. ;

Creelan, Ben C. ;

Antonia, Scott J. ;

Caudell, Jimmy J. ;

Harrison, Louis B. ;

Sahebjam, Solmaz ;

Gray, Jhanelle E. ;

Etame, Arnold B. ;

Johnstone, Peter A. ;

Yu, Michael ;

Perez, Bradford A. .

JOURNAL OF NEURO-ONCOLOGY, 2017, 133 (02) :331-338

[4] Stereotactic radiosurgery of early melanoma brain metastases after initiation of anti-CTLA-4 treatment is associated with improved intracranial control [J].

An, Yi ;

Jiang, Wen ;

Kim, Betty Y. S. ;

Qian, Jack M. ;

Tang, Chad ;

Fang, Penny ;

Logan, Jennifer ;

D'Souza, Neil M. ;

Haydu, Lauren E. ;

Wang, Xin A. ;

Hess, Kenneth R. ;

Kluger, Harriet ;

Glitza, Isabella C. ;

Mahajan, Anita ;

Welsh, James W. ;

Lin, Steven H. ;

Yu, James B. ;

Davies, Michael A. ;

Hwu, Patrick ;

Sulman, Erik P. ;

Brown, Paul D. ;

Chiang, Veronica L. S. ;

Li, Jing .

RADIOTHERAPY AND ONCOLOGY, 2017, 125 (01) :80-88

[5] Durvalumab after Chemoradiotherapy in Stage III Non-Small-Cell Lung Cancer [J].

Antonia, S. J. ;

Villegas, A. ;

Daniel, D. ;

Vicente, D. ;

Murakami, S. ;

Hui, R. ;

Yokoi, T. ;

Chiappori, A. ;

Lee, K. H. ;

de Wit, M. ;

Cho, B. C. ;

Bourhaba, M. ;

Quantin, X. ;

Tokito, T. ;

Mekhail, T. ;

Planchard, D. ;

Kim, Y. -C. ;

Karapetis, C. S. ;

Hiret, S. ;

Ostoros, G. ;

Kubota, K. ;

Gray, J. E. ;

Paz-Ares, L. ;

de Castro Carpeno, J. ;

Wadsworth, C. ;

Melillo, G. ;

Jiang, H. ;

Huang, Y. ;

Dennis, P. A. ;

Ozguroglu, M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2017, 377 (20) :1919-1929

[6] Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases - A randomized controlled trial [J].

Aoyama, Hidefumi ;

Shirato, Hiroki ;

Tago, Masao ;

Nakagawa, Keiichi ;

Toyoda, Tatsuya ;

Hatano, Kazuo ;

Kenjyo, Masahiro ;

Oya, Natsuo ;

Hirota, Saeko ;

Shioura, Hiroki ;

Kunieda, Etsuo ;

Inomata, Taisuke ;

Hayakawa, Kazushige ;

Katoh, Norio ;

Kobashi, Gen .

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2006, 295 (21) :2483-2491

[7] Nivolumab versus Docetaxel in Advanced Squamous-Cell Non-Small-Cell Lung Cancer [J].

Brahmer, Julie ;

Reckamp, Karen L. ;

Baas, Paul ;

Crino, Lucio ;

Eberhardt, Wilfried E. E. ;

Poddubskaya, Elena ;

Antonia, Scott ;

Pluzanski, Adam ;

Vokes, Everett E. ;

Holgado, Esther ;

Waterhouse, David ;

Ready, Neal ;

Gainor, Justin ;

Aren Frontera, Osvaldo ;

Havel, Libor ;

Steins, Martin ;

Garassino, Marina C. ;

Aerts, Joachim G. ;

Domine, Manuel ;

Paz-Ares, Luis ;

Reck, Martin ;

Baudelet, Christine ;

Harbison, Christopher T. ;

Lestini, Brian ;

Spigel, David R. .

NEW ENGLAND JOURNAL OF MEDICINE, 2015, 373 (02) :123-135

[8] Neurocognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole-brain irradiation: a randomised controlled trial [J].

Chang, Eric L. ;

Wefel, Jeffrey S. ;

Hess, Kenneth R. ;

Allen, Pamela K. ;

Lang, Frederick F. ;

Kornguth, David G. ;

Arbuckle, Rebecca B. ;

Swint, J. Michael ;

Shiu, Almon S. ;

Maor, Moshe H. ;

Meyers, Christina A. .

LANCET ONCOLOGY, 2009, 10 (11) :1037-1044

[9] Challenges With the Diagnosis and Treatment of Cerebral Radiation Necrosis [J].

Chao, Samuel T. ;

Ahluwalia, Manmeet S. ;

Barnett, Gene H. ;

Stevens, Glen H. J. ;

Murphy, Erin S. ;

Stockham, Abigail L. ;

Shiue, Kevin ;

Suh, John H. .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2013, 87 (03) :449-457

[10] Concurrent Immune Checkpoint Inhibitors and Stereotactic Radiosurgery for Brain Metastases in Non-Small Cell Lung Cancer, Melanoma, and Renal Cell Carcinoma [J].

Chen, Linda ;

Douglass, Jacqueline ;

Kleinberg, Lawrence ;

Ye, Xiaobu ;

Marciscano, Ariel E. ;

Forde, Patrick M. ;

Brahmer, Julie ;

Lipson, Evan ;

Sharfman, William ;

Hammers, Hans ;

Naidoo, Jarushka ;

Bettegowda, Chetan ;

Lim, Michael ;

Redmond, Kristin J. .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2018, 100 (04) :916-925

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