Background: To define efficacy and toxicity of Immunotherapy (IT) with stereotactic radiotherapy (SRT) including radiosurgery (RS) or hypofractionated SRT (HFSRT) for brain metastases (BM) from non-small cell lung cancer (NSCLC) in a multicentric retrospective study from AIRO (Italian Association of Radiotherapy and Clinical Oncology). Methods: NSCLC patients with BM receiving SRT + IT and treated in 19 Italian centers were analyzed and compared with a control group of patients treated with exclusive SRT. Results: One hundred patients treated with SRT + IT and 50 patients treated with SRT-alone were included. Patients receiving SRT + IT had a longer intracranial Local Progression-Free Survival (iLPFS) (propensity score-adjusted P =. 007). Among patients who, at the diagnosis of BM, received IT and had also extracranial progression (n = 24), IT administration after SRT was shown to be related to a better overall survival (OS) (P =. 037). A multivariate analysis, non-adenocarcinoma histology, KPS = 70 and use of HFSRT were associated with a significantly worse survival (P =. 019, P =. 017 and P =. 007 respectively). Time interval between SRT and IT ≤7 days (n = 90) was shown to be related to a longer OS if compared to SRT-IT interval >7 days (n = 10) (propensity score-adjusted P =. 008). The combined treatment was well tolerated. No significant difference in terms of radionecrosis between SRT + IT patients and SRT-alone patients was observed. The time interval between SRT and IT had no impact on the toxicity rate. Conclusions: Combined SRT + IT was a safe approach, associated with a better iLPFS if compared to exclusive SRT.

Immunotherapy in association with stereotactic radiotherapy for non-small cell lung cancer brain metastases: results from a multicentric retrospective study on behalf of AIRO / Scoccianti S.; Olmetto E.; Pinzi V.; Osti M.F.; Di Franco R.; Caini S.; Anselmo P.; Matteucci P.; Franceschini D.; Mantovani C.; Beltramo G.; Pasqualetti F.; Bruni A.; Tini P.; Giudice E.; Ciammella P.; Merlotti A.; Pedretti S.; Trignani M.; Krengli M.; Giaj-Levra N.; Desideri I.; Pecchioli G.; Muto P.; Maranzano E.; Fariselli L.; Navarria P.; Ricardi U.; Scotti V.; Livi L.. - In: NEURO-ONCOLOGY. - ISSN 1522-8517. - ELETTRONICO. - 23:(2021), pp. 1750-1764. [10.1093/neuonc/noab129]

Immunotherapy in association with stereotactic radiotherapy for non-small cell lung cancer brain metastases: results from a multicentric retrospective study on behalf of AIRO

Olmetto E.;Caini S.;Desideri I.;Pecchioli G.;Scotti V.;Livi L.
2021

Abstract

Background: To define efficacy and toxicity of Immunotherapy (IT) with stereotactic radiotherapy (SRT) including radiosurgery (RS) or hypofractionated SRT (HFSRT) for brain metastases (BM) from non-small cell lung cancer (NSCLC) in a multicentric retrospective study from AIRO (Italian Association of Radiotherapy and Clinical Oncology). Methods: NSCLC patients with BM receiving SRT + IT and treated in 19 Italian centers were analyzed and compared with a control group of patients treated with exclusive SRT. Results: One hundred patients treated with SRT + IT and 50 patients treated with SRT-alone were included. Patients receiving SRT + IT had a longer intracranial Local Progression-Free Survival (iLPFS) (propensity score-adjusted P =. 007). Among patients who, at the diagnosis of BM, received IT and had also extracranial progression (n = 24), IT administration after SRT was shown to be related to a better overall survival (OS) (P =. 037). A multivariate analysis, non-adenocarcinoma histology, KPS = 70 and use of HFSRT were associated with a significantly worse survival (P =. 019, P =. 017 and P =. 007 respectively). Time interval between SRT and IT ≤7 days (n = 90) was shown to be related to a longer OS if compared to SRT-IT interval >7 days (n = 10) (propensity score-adjusted P =. 008). The combined treatment was well tolerated. No significant difference in terms of radionecrosis between SRT + IT patients and SRT-alone patients was observed. The time interval between SRT and IT had no impact on the toxicity rate. Conclusions: Combined SRT + IT was a safe approach, associated with a better iLPFS if compared to exclusive SRT.
2021
23
1750
1764
Scoccianti S.; Olmetto E.; Pinzi V.; Osti M.F.; Di Franco R.; Caini S.; Anselmo P.; Matteucci P.; Franceschini D.; Mantovani C.; Beltramo G.; Pasqualetti F.; Bruni A.; Tini P.; Giudice E.; Ciammella P.; Merlotti A.; Pedretti S.; Trignani M.; Krengli M.; Giaj-Levra N.; Desideri I.; Pecchioli G.; Muto P.; Maranzano E.; Fariselli L.; Navarria P.; Ricardi U.; Scotti V.; Livi L.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1282656
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 33
  • ???jsp.display-item.citation.isi??? 29
social impact