Stereotactic Radiosurgery and Immune Checkpoint Inhibitors in the Management of Brain Metastases.

ABSTRACT: Brain metastases traditionally carried a poor prognosis with an overall survival of weeks to months in the absence of treatment. Radiation therapy modalities include whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS). WBRT delivers a relatively low dose of radiation, has neurocognitive sequelae, and has not been investigated for its immunostimulatory effects. Furthermore, WBRT exposes the entire intracranial tumor immune microenvironment to radiation. SRS delivers a high dose of conformal radiation with image guidance to minimize dose to surrounding normal brain tissue, and appears to promote anti-tumor immunity. In parallel with many of these discoveries, immune checkpoint inhibitors (ICIs) have demonstrated a survival advantage in multiple malignancies commonly asso

SUBMITTER: Lehrer EJ 

PROVIDER: S-EPMC6213912 | biostudies-literature | 2018 Oct

REPOSITORIES: biostudies-literature