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Research ArticleClinical Studies

Stereotactic and Hypofractionated Radiotherapy Associated With Immune Checkpoint Inhibitor Drugs: Analysis of Local Control, Toxicity, and Outcome in a Single Research Centre Case Study

DIMITRI ANZELLINI, VITALIANA DE SANCTIS, MAURIZIO VALERIANI, CHIARA REVERBERI, LUCA MARINELLI, MARIA MASSARO, GIANLUCA VULLO, GIUSEPPE FACONDO, RICCARDO CARLO SIGILLO, EMANUELE TOSI and MATTIA FALCHETTO OSTI
Anticancer Research October 2021, 41 (10) 5107-5116; DOI: https://doi.org/10.21873/anticanres.15327
DIMITRI ANZELLINI
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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  • For correspondence: dimitrianzellini@gmail.com
VITALIANA DE SANCTIS
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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MAURIZIO VALERIANI
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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CHIARA REVERBERI
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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LUCA MARINELLI
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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MARIA MASSARO
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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GIANLUCA VULLO
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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GIUSEPPE FACONDO
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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RICCARDO CARLO SIGILLO
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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EMANUELE TOSI
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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MATTIA FALCHETTO OSTI
Department of Medicine and Surgery and Translational Medicine, Radiation Oncology, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
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Abstract

Background/Aim: We evaluated local control and toxicity in patients receiving radiotherapy associated with immune check point inhibitors and analyzed which oligometastatic disease setting benefits the most from local ablation in terms of advantage in overall survival. Patients and Methods: We retrospectively identified 60 oligoprogressive patients treated with a PD-1 inhibitor in association with radiotherapy on the site of progression (119 lesions). Results: After a median follow-up of 11.7 months (range=1-39 months), we observed complete response (CR) in 45/119, partial response (RP) in 42/119, and stable disease (SD) in 30/119 patients. Nine radionecrotic events occurred. Two patients experienced grade 3 toxicities and 32 patients reported grade 2 toxicities. The number of radiologically evident metastatic organs in patients who received concomitant PD-1 inhibitors and radiotherapy showed a significant increase in survival (respectively, 73% after 12 months and 47% after 24 months) in patients with 0-3 metastatic organs compared to those with more than 3 organ sites involved (p<0.0001). Conclusion: Radiotherapy associated with PD-1 inhibitors is overall safe and efficacious. Patients eligible for intensification of local treatments should have less or equal to 3 metastatic organ sites.

Key Words:
  • Radiotherapy
  • immunotherapy
  • stereotactic radiotherapy
  • intensity-modulated radiation therapy
  • hypofractionated radiotherapy
  • target therapies
  • immune checkpoint inhibitor
  • Received June 15, 2021.
  • Revision received July 15, 2021.
  • Accepted August 23, 2021.
  • Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 41 (10)
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October 2021
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Stereotactic and Hypofractionated Radiotherapy Associated With Immune Checkpoint Inhibitor Drugs: Analysis of Local Control, Toxicity, and Outcome in a Single Research Centre Case Study
DIMITRI ANZELLINI, VITALIANA DE SANCTIS, MAURIZIO VALERIANI, CHIARA REVERBERI, LUCA MARINELLI, MARIA MASSARO, GIANLUCA VULLO, GIUSEPPE FACONDO, RICCARDO CARLO SIGILLO, EMANUELE TOSI, MATTIA FALCHETTO OSTI
Anticancer Research Oct 2021, 41 (10) 5107-5116; DOI: 10.21873/anticanres.15327

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Stereotactic and Hypofractionated Radiotherapy Associated With Immune Checkpoint Inhibitor Drugs: Analysis of Local Control, Toxicity, and Outcome in a Single Research Centre Case Study
DIMITRI ANZELLINI, VITALIANA DE SANCTIS, MAURIZIO VALERIANI, CHIARA REVERBERI, LUCA MARINELLI, MARIA MASSARO, GIANLUCA VULLO, GIUSEPPE FACONDO, RICCARDO CARLO SIGILLO, EMANUELE TOSI, MATTIA FALCHETTO OSTI
Anticancer Research Oct 2021, 41 (10) 5107-5116; DOI: 10.21873/anticanres.15327
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Keywords

  • radiotherapy
  • immunotherapy
  • stereotactic radiotherapy
  • intensity-modulated radiation therapy
  • hypofractionated radiotherapy
  • target therapies
  • immune checkpoint inhibitor
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