Immunotherapeutic checkpoint inhibitors are commonly used in patients with melanoma, non–small cell lung cancer (NSCLC), and renal cell carcinoma (RCC), all cancers that frequently metastasize to the brain. Radiation therapy is frequently used for brain metastases because few systemic agents effectively penetrate the blood-brain barrier. The most deleterious consequence of brain-directed, stereotactic radiation is radiation necrosis—inflammation and/or injury to the brain abutting the treated tumor.¹ Published literature has suggested that brain-directed stereotactic radiation in patients also receiving immunotherapy may yield beneficial, synergistic effects; however, few studies have examined radiation necrosis. We investigated the association between immunotherapy and symptomatic radiation necrosis in patients with melanoma, NSCLC, or RCC and newly diagnosed brain metastases treated with stereotactic radiation.

免疫治疗检查点抑制剂通常用于黑色素瘤，非小细胞肺癌（NSCLC）和肾细胞癌（RCC）的患者，所有这些癌症均会转移至大脑。放射疗法常用于脑转移，因为很少有全身性药物能有效穿透血脑屏障。定向立体定向辐射的最有害后果是辐射坏死，即炎症和/或对治疗肿瘤附近的大脑的伤害。^1个已发表的文献表明，在接受免疫治疗的患者中，脑定向立体定向放射治疗可能产生有益的协同作用。但是，很少有研究检查放射线坏死。我们调查了黑色素瘤，NSCLC或RCC以及接受立体定向放射治疗的新诊断脑转移患者的免疫疗法与有症状放射坏死之间的关联。