Abstract:

Objective To evaluate the efficacy and safety of PD⁃1 Inhibitor combined with brain radiotherapy for brain metastases in patients with pan negative non⁃small cell lung cancer（NSCLC）. Methods The clinical data of 62 pan ⁃negative NSCLC patients with brain metastases treated at our hospital between August 2016 and August 2021 were retrospectively analyzed to compare the local control rate of brain metastases，incidence of new intracranial lesions，overall survival，progression ⁃ free survival and occurrence of adverse reactions between the group with radiation therapy alone and the group with radiation plus anti⁃PD⁃1 therapy. Results The incidence of new intracranial lesions in the former andlatter groupwas 54.1%（20/37）and 28.0%（7/25），respectively（P = 0.042）. The median progression free survival（PFS）for the latter group was 1.5 months longer than the latter group （P = 0.005）. The median overall survival（OS）of the group with the radiation plus anti ⁃ PD ⁃ 1 therapy was 3.6 months longer than the group with radiation therapy alone（P = 0.016）. Treatment modality was an independent risk factor for both PFS（P = 0.004）and OS（P = 0.01）. The adverse effects could be tolerated. Conclusion For pan⁃negative NSCLC patients with brain metastases，radiation plus anti⁃PD⁃1 therapy may prolong PFS and OS， with the adverse reactions tolerable.

Key words:

non ?small cell lung cancer, immunotherapy, radiation therapy, immune checkpoint inhibitors, brain metastasis