Scholarlink

Background <p>Brain metastasis (BM) remains a major therapeutic challenge in non-small cell lung cancer (NSCLC) without actionable driver mutations. Radiotherapy combined with immune checkpoint inhibitors (ICIs) may enhance intracranial control through synergistic immune activation. This study evaluated the efficacy of radiotherapy plus ICI and explored prognostic factors influencing outcomes in patients with NSCLC-BM.</p> Methods <p>We retrospectively analyzed 116 patients with measurable, driver-negative NSCLC-BM treated between June 2019 and December 2024. Patients were divided into two groups: Radiotherapy combined with ICI plus chemotherapy (RT + ICI, <i>n</i> = 56) and ICI plus chemotherapy (ICI, <i>n</i> = 60). Intracranial and systemic objective response rates (iORR, sORR) and progression-free survival (iPFS, sPFS) were analyzed. Prognostic factors, including the prognostic nutritional index (PNI), were assessed using Cox regression analyses.</p> Results <p>Compared with the ICI group, the RT + ICI group demonstrated a significantly higher iORR (78.6% vs 40.0%, <i>P</i> &lt; 0.001) and significantly longer median iPFS (11.8 vs 7.9&#xa0;months; hazard ratio [HR] = 0.48, 95% confidence intervals [CI] 0.30–0.77, <i>P</i> = 0.002), and sPFS (8.9 vs 5.9&#xa0;months; HR = 0.58, 95% CI 0.38–0.89, <i>P</i> = 0.014). High PNI (≥ 42.15) was independently associated with prolonged iPFS (HR = 8.77, 95% CI 2.91–26.47, <i>P</i> &lt; 0.001) and sPFS (HR = 8.46, 95% CI 3.39–21.10, <i>P</i> &lt; 0.001).</p> Conclusion <p>Radiotherapy combined with immunochemotherapy was associated with improved intracranial and systemic outcomes compared to immunochemotherapy alone in patients with driver-negative NSCLC-BM. Additionally, PNI shows potential as a useful biomarker for predicting therapeutic outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Brain radiotherapy combined with immune checkpoint inhibitors and chemotherapy as first-line treatment for advanced non-small cell lung cancer with brain metastases: a retrospective study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月19日

查看全文
  • Wenjie Wu,
  • Ting Zhong,
  • Xiaolong Zhou,
  • Weiqiong Chen,
  • Xing Zhang,
  • Huiming Xu,
  • Zian Tang,
  • Wenkai He,
  • Yijian Wang,
  • Gongrang Chen,
  • Yan Wang,
  • Boyu Liu,
  • Yingjie Liu,
  • Yongping Han,
  • Kaili Lu,
  • Yaoheng Wang,
  • Bing Zhang,
  • Lingjun Xiao,
  • Ziyun Du,
  • Quan Liu,
  • Juan Liang,
  • Xiantao Li,
  • Lianxi Song

摘要

Background

Brain metastasis (BM) remains a major therapeutic challenge in non-small cell lung cancer (NSCLC) without actionable driver mutations. Radiotherapy combined with immune checkpoint inhibitors (ICIs) may enhance intracranial control through synergistic immune activation. This study evaluated the efficacy of radiotherapy plus ICI and explored prognostic factors influencing outcomes in patients with NSCLC-BM.

Methods

We retrospectively analyzed 116 patients with measurable, driver-negative NSCLC-BM treated between June 2019 and December 2024. Patients were divided into two groups: Radiotherapy combined with ICI plus chemotherapy (RT + ICI, n = 56) and ICI plus chemotherapy (ICI, n = 60). Intracranial and systemic objective response rates (iORR, sORR) and progression-free survival (iPFS, sPFS) were analyzed. Prognostic factors, including the prognostic nutritional index (PNI), were assessed using Cox regression analyses.

Results

Compared with the ICI group, the RT + ICI group demonstrated a significantly higher iORR (78.6% vs 40.0%, P < 0.001) and significantly longer median iPFS (11.8 vs 7.9 months; hazard ratio [HR] = 0.48, 95% confidence intervals [CI] 0.30–0.77, P = 0.002), and sPFS (8.9 vs 5.9 months; HR = 0.58, 95% CI 0.38–0.89, P = 0.014). High PNI (≥ 42.15) was independently associated with prolonged iPFS (HR = 8.77, 95% CI 2.91–26.47, P < 0.001) and sPFS (HR = 8.46, 95% CI 3.39–21.10, P < 0.001).

Conclusion

Radiotherapy combined with immunochemotherapy was associated with improved intracranial and systemic outcomes compared to immunochemotherapy alone in patients with driver-negative NSCLC-BM. Additionally, PNI shows potential as a useful biomarker for predicting therapeutic outcomes.