The Association of Radiation Dose-Fractionation and Immunotherapy Use With Overall Survival in Metastatic Melanoma Patients

医学 黑色素瘤 倾向得分匹配 分馏 内科学 比例危险模型 剂量分馏 免疫疗法 放射治疗 肿瘤科 生存分析 癌症 胃肠病学 核医学 癌症研究 有机化学 化学
作者
Shang-Jui Wang,Sachin R. Jhawar,Zorimar Rivera‐Núñez,Ann W. Silk,Jaemin Byun,Eric D. Miller,Dukagjin Blakaj,Rahul R. Parikh,Joseph Weiner,Sharad Goyal
出处
期刊:Cureus [Cureus, Inc.]
被引量:8
标识
DOI:10.7759/cureus.8767
摘要

ObjectiveMetastatic melanoma patients often receive palliative radiotherapy (RT) and immunotherapy (IT).However, the immunological interplay between RT dose-fractionation and IT is uncertain, and the optimal treatment strategy using RT and IT in metastatic melanoma remains unclear.Our main objective was to examine the effect of RT dose-fractionation on overall survival (OS). MethodsUsing the National Cancer Database (NCDB), we classified metastatic melanoma patients who received palliative RT into two dose-fractionation groups -conventionally fractionated RT (CFRT; <5 Gy/fraction) and hypofractionated RT (HFRT: ≥5 Gy/fraction) -with or without IT.Survival analysis was performed using the Cox regression model, Kaplan-Meier method, and propensity-score matching (PSM). ResultsA total of 5,281 metastatic melanoma patients were included, with a median follow-up of 5.9 months.The three-year OS was highest in patients who received HFRT+IT [37.3% (95% CI: 31.1-43.5)]compared to those who received HFRT alone [19.0%(95% CI: 16.2-21.9)],)], or CFRT alone [8.6% (95%CI: 7.6-9.7);p<0.0001].The magnitude of OS benefit with the use of IT was greater in those who received HFRT (18.3%) compared with those who received CFRT (9.0%) (p<0.0001).The addition of IT to HFRT, compared to CFRT, was associated with greater OS benefit in patients treated with RT to the brain and soft tissue/visceral (STV) sites.On PSM analysis, HFRT+IT was associated with improved three-year OS compared to other treatments. ConclusionMetastatic melanoma patients who received HFRT+IT was associated with the greatest OS benefit.Our findings warrant further prospective evaluation as to whether higher RT dose-per-fraction improves clinical outcomes in metastatic melanoma patients receiving IT.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
刚刚
隐形曼青应助林子青采纳,获得10
刚刚
深情安青应助冬去春来采纳,获得10
1秒前
1秒前
Erislastem发布了新的文献求助10
1秒前
彭于彦祖应助鱼咬羊采纳,获得30
1秒前
znn发布了新的文献求助10
2秒前
乐乐应助高工采纳,获得10
2秒前
2秒前
大聪明发布了新的文献求助10
2秒前
3秒前
李fr发布了新的文献求助10
4秒前
4秒前
Whisper完成签到 ,获得积分10
4秒前
小饼干完成签到,获得积分20
4秒前
小蘑菇应助Eric采纳,获得30
5秒前
5秒前
W_King完成签到,获得积分10
5秒前
6秒前
hhhh发布了新的文献求助10
6秒前
研友_VZG7GZ应助shain采纳,获得10
6秒前
7秒前
李大了完成签到,获得积分10
8秒前
8秒前
8秒前
观妙散人完成签到,获得积分10
8秒前
深情安青应助leo_zjm采纳,获得10
9秒前
fff发布了新的文献求助10
9秒前
轻松的惜芹应助黄茹采纳,获得30
9秒前
9秒前
Erislastem完成签到,获得积分10
10秒前
10秒前
10秒前
health完成签到,获得积分10
11秒前
11秒前
小梦发布了新的文献求助10
11秒前
12秒前
wbh完成签到 ,获得积分10
12秒前
可能发布了新的文献求助10
12秒前
Jasen发布了新的文献求助10
12秒前
高分求助中
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Effective Learning and Mental Wellbeing 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3974779
求助须知:如何正确求助?哪些是违规求助? 3519193
关于积分的说明 11197417
捐赠科研通 3255311
什么是DOI,文献DOI怎么找? 1797760
邀请新用户注册赠送积分活动 877150
科研通“疑难数据库(出版商)”最低求助积分说明 806187