Efficacy and Safety of Different Fractions in Stereotactic Radiotherapy Combined with PD-1/PD-L1 Inhibitor in the Treatment of Brain Metastasis of Non-Small Cell Lung Cancer
Objective To compare the efficacy and safety of different fractions in stereotactic radiotherapy combined with programmed cell death protein 1(PD-1)/programmed cell death-ligand 1(PD-L1)inhibitor in the treatment of brain metas-tasis of non-small cell lung cancer.Methods 50 patients with brain metastasis from non-small cell lung cancer were enrolled.All patients received stereotactic radiotherapy combined with PD-1PD-L1 inhibitors.Patients were classified into group A(n=15),group B(n=15)and group C(n=20)according to the dose of fractionated stereotactic radiotherapy.The prescribed dose was 48 Gy in 12 fractions(4 Gy/fraction)in group A,40 Gy in 8 fractions(5 Gy/fraction)in group B,and 35 Gy in 5 fractions(7 Gy/fraction)in group B.The clinical efficacy,adverse reaction rate,survival status and Karnofsky Performance Scale(KPS)score were compared among the 3 groups.Results The overall efficacy rate yielded statistical difference presented in comparison a-mong the 3 groups,and was the highest in group C compared with group A and B(P＜0.05).The adverse reaction rate demon-strated no statistical difference among three groups(P＞0.05).The 2-year progression-free survival time was 2.70 months in group A,2.40 months in group B and 6.60 months in group C.Log-rank test results indicated that the progression-free survival showed statistical difference among three groups(P＜0.05).After treatment,KPS score was significantly increased in all three groups,and group C scored the highest on KPS than group A and B,with statistical difference in paired comparison(all P＜0.05).Conclusion Compared with doses in 12 f of 4 Gy and 8 f of 5 Gy,stereotactic radiotherapy at doses in 5 f of 7 Gy com-bined with PD-1/PD-L1 inhibitor for non-small cell lung cancer patients with brain metastasis obtains better clinical efficacy,which can effectively prolong the survival time and improve the quality of life.
万方数据
维普
