医学
放射治疗
背向效应
放射外科
不利影响
内科学
肿瘤科
黑色素瘤
肺癌
肺炎
剂量分馏
癌症
肺
免疫疗法
癌症研究
作者
P. Damen,KARIJN P.M. SUIJKERBUIJK,Anne S R van Lindert,Wietse S.C. Eppinga,Sherif Y. El Sharouni,Joost J.C. Verhoeff
出处
期刊:Anticancer Research
[Anticancer Research USA Inc.]
日期:2022-10-01
卷期号:42 (10): 4795-4804
被引量:3
标识
DOI:10.21873/anticanres.15984
摘要
Abstract
Background/Aim: Recent studies described the safety and clinical utility of combined anti-programmed cell death protein-1 (anti-PD1) checkpoint inhibition with radiotherapy. However, long-term follow-up data are lacking. Abscopal effects have been hypothesized, though clinical proof is still scarce. Patients and Methods: We analyzed the efficacy and toxicity of combined (stereotactic) radiotherapy and anti-PD1 in consecutive oligoprogressive melanoma and non-small cell lung cancer (NSCLC) patients who were irradiated for 1 to 3 progressive metastases during anti-PD-1 in our institute between January 2017 and January 2019 and verified one-dimensional RECIST measurements by volumetric assessments. Results: Out of 361 patients, 11 melanoma and 5 NSCLC patients were included in this series. Radiotherapy was applied after a median of 11 months (range=1-30 months) from the start of anti-PD1 treatment. No increased risk of adverse events for the combined treatments was observed. With a median follow-up of 4.9 years since the start of anti-PD1, 69% of patients were alive. Six of 16 patients had stable disease after a median follow-up of 4.1 years after radiotherapy. Abscopal effects were suspected in three out of 16 patients. However, if volumetric assessment was used, two of these patients already had tumor shrinkage prior to radiotherapy, not detected by one-dimensional measurements. Conclusion: Stereotactic radiotherapy for oligoprogressive disease during PD1-inhibition can induce long-term disease control. Although abscopal effects were suspected in three patients, they were not confirmed with volumetric assessment in two patients. The discrepancy found between one-dimensional and volumetric response assessment argues for including volumetric assessment in further studies.
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