The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From Melanoma
ABSTRACT Background Melanoma is one of the most common causes of brain metastases (BM). Despite recent therapeutic advances, survival in patients with brain metastases from melanoma (MBM) is dismal. In this study, we analyse the effect of concomitant treatment with stereotactic radiotherapy (SRT) an...
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2025-06-01
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| Online Access: | https://doi.org/10.1002/cam4.70923 |
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| author | Chiel B. Nijboer Djura Piersma Angelique E. J. Sijben Besim Hoti Matthijs van der Meulen |
| author_facet | Chiel B. Nijboer Djura Piersma Angelique E. J. Sijben Besim Hoti Matthijs van der Meulen |
| author_sort | Chiel B. Nijboer |
| collection | DOAJ |
| description | ABSTRACT Background Melanoma is one of the most common causes of brain metastases (BM). Despite recent therapeutic advances, survival in patients with brain metastases from melanoma (MBM) is dismal. In this study, we analyse the effect of concomitant treatment with stereotactic radiotherapy (SRT) and immunotherapy on survival, and of the location of BM on survival. Methods All patients with MBM diagnosed in Medisch Spectrum Twente, between 2011 and 2023 were included. Patient, radiological, and treatment variables were retrospectively collected. The primary outcome was overall survival (OS) and the secondary outcome was intracranial progression‐free survival (IPFS). The effect of combination treatment (IRT), location, and other known prognostic factors on outcome measures was analysed using univariate and multivariate Cox regression. Location groups were divided into only supratentorial, only infratentorial, and both infra‐ and supratentorial BM. Results 92 patients with MBM were included. The mean age was 64 years with standard deviation (SD) 12, median OS [interquartile range (IQR)] was 9.8 months [4.0–31.0] in the total population. No difference in OS was found between different treatment regimens (n = 56). Patients having both infra‐ and supratentorial BM showed a significantly reduced OS compared to having only supratentorial BM in multivariate analysis (Hazard Ratio (HR): 2.81; 95% Confidence Interval (CI):1.37–5.74; p < 0.01). IRT had a significantly positive effect on IPFS in univariate analysis (HR: 0.32; 95% CI: 0.13–0.77; p = 0.01). Conclusion Concomitant treatment of immunotherapy and SRT is associated with a prolonged IPFS compared to immunotherapy only. Having both infra‐ and supratentorial BM is an independent prognostic factor for a shorter OS. |
| format | Article |
| id | doaj-art-e2cd58f5477e4f139e100577091111e8 |
| institution | DOAJ |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-e2cd58f5477e4f139e100577091111e82025-08-20T03:21:19ZengWileyCancer Medicine2045-76342025-06-011411n/an/a10.1002/cam4.70923The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From MelanomaChiel B. Nijboer0Djura Piersma1Angelique E. J. Sijben2Besim Hoti3Matthijs van der Meulen4Department of Neurology Medisch Spectrum Twente Enschede the NetherlandsDepartment of Internal Medicine Medisch Spectrum Twente Enschede the NetherlandsDepartment of Neurology Medisch Spectrum Twente Enschede the NetherlandsDepartment of Neurology Medisch Spectrum Twente Enschede the NetherlandsDepartment of Neurology Medisch Spectrum Twente Enschede the NetherlandsABSTRACT Background Melanoma is one of the most common causes of brain metastases (BM). Despite recent therapeutic advances, survival in patients with brain metastases from melanoma (MBM) is dismal. In this study, we analyse the effect of concomitant treatment with stereotactic radiotherapy (SRT) and immunotherapy on survival, and of the location of BM on survival. Methods All patients with MBM diagnosed in Medisch Spectrum Twente, between 2011 and 2023 were included. Patient, radiological, and treatment variables were retrospectively collected. The primary outcome was overall survival (OS) and the secondary outcome was intracranial progression‐free survival (IPFS). The effect of combination treatment (IRT), location, and other known prognostic factors on outcome measures was analysed using univariate and multivariate Cox regression. Location groups were divided into only supratentorial, only infratentorial, and both infra‐ and supratentorial BM. Results 92 patients with MBM were included. The mean age was 64 years with standard deviation (SD) 12, median OS [interquartile range (IQR)] was 9.8 months [4.0–31.0] in the total population. No difference in OS was found between different treatment regimens (n = 56). Patients having both infra‐ and supratentorial BM showed a significantly reduced OS compared to having only supratentorial BM in multivariate analysis (Hazard Ratio (HR): 2.81; 95% Confidence Interval (CI):1.37–5.74; p < 0.01). IRT had a significantly positive effect on IPFS in univariate analysis (HR: 0.32; 95% CI: 0.13–0.77; p = 0.01). Conclusion Concomitant treatment of immunotherapy and SRT is associated with a prolonged IPFS compared to immunotherapy only. Having both infra‐ and supratentorial BM is an independent prognostic factor for a shorter OS.https://doi.org/10.1002/cam4.70923brain metastasesimmunotherapymelanomaprognosisradiation |
| spellingShingle | Chiel B. Nijboer Djura Piersma Angelique E. J. Sijben Besim Hoti Matthijs van der Meulen The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From Melanoma Cancer Medicine brain metastases immunotherapy melanoma prognosis radiation |
| title | The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From Melanoma |
| title_full | The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From Melanoma |
| title_fullStr | The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From Melanoma |
| title_full_unstemmed | The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From Melanoma |
| title_short | The Effect of Concomitant Immunotherapy and Stereotactic Radiotherapy, and of Location on Survival in Patients With Brain Metastases From Melanoma |
| title_sort | effect of concomitant immunotherapy and stereotactic radiotherapy and of location on survival in patients with brain metastases from melanoma |
| topic | brain metastases immunotherapy melanoma prognosis radiation |
| url | https://doi.org/10.1002/cam4.70923 |
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