Management outcomes for biopsy-proven radiation necrosis in patients with brain metastases in the era of immune-checkpoint blockade.

ABSTRACT:

Purpose

Immunotherapy and stereotactic radiosurgery (SRS) are frequently combined in the management of brain metastases from non-small cell lung cancer (NSCLC) and melanoma. However, concurrent SRS and dual immune-checkpoint inhibition (ICPI) elevate the risk for symptomatic radionecrosis. As optimal radionecrosis management in the setting of immunotherapy is unknown, we aimed to characterize our institutional approaches and outcomes in patients with biopsy-proven radionecrosis.

Methods

Patients with NSCLC and melanoma brain metastases treated with SRS from 2014 to 2022 were identified from a prospective database. Only cases with biopsy-confirmed radionecrosis were included. The primary outcome was radiographic stabilization following treatment. Secondary outcomes included s

SUBMITTER: Seidel JA 

PROVIDER: S-EPMC12337231 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature