ABSTRACT
This review of the literature provides an overview of the combination of stereotactic radiotherapy (SBRT) with immune checkpoint inhibitors (ICI) and tyrosine kinase inhibitors (TKI) in oligo-progressive non-small cell lung neoplasia. This combination showed local control of 76-100% and distant response rates of 8-60%. They reported progression-free survival of 2.7-24 months and overall survival of 13.4-41.2 months. All-grade toxicity rates ranged from 0% to 42%, with grade≥3 toxicity ranging from 0% to 14%. The combination of SBRT with ICI or TKIs exhibits a safe profile with high rates of local control with this combination. This could delay the use of a new line of systemic therapy in these patients with often limited therapeutic resources.
Cette revue de la littérature réalise un état des lieux de l'association de la radiothérapie stéréotaxique (SBRT) aux inhibiteurs de points de contrôle immunitaire (IPCI) et inhibiteurs de la tyrosine kinase (ITK) dans les néoplasies pulmonaires non à petites cellules en oligoprogression. Cette association montrait un contrôle local entre 76 et 100 % et un taux de réponse à distance entre 8 et 60 %. Elle était associée à une survie sans progression de 2,7 à 24 mois et une survie globale de 13,4 à 41,2 mois. Les taux de toxicité tous grades confondus étaient de 0 à 42 %, dont ceux de grade ≥ 3 entre 0 et 14 %. L'association de la SBRT aux IPCI ou ITK arbore un profil de sécurité avec des taux élevés de contrôle local avec cette combinaison. Cela pourrait retarder le recours à une nouvelle ligne de traitement systémique chez ces patients aux ressources thérapeutiques souvent limitées.
Subject(s)
Carcinoma, Non-Small-Cell Lung , Lung Neoplasms , Radiosurgery , Carcinoma, Non-Small-Cell Lung/radiotherapy , Humans , Lung , Lung Neoplasms/drug therapy , Lung Neoplasms/radiotherapyABSTRACT
OBJECTIVE: According to recent European Society of Medical Oncology, European Society of Gynaecological Oncology and European Society of Radiotherapy and Oncology guidelines, adjuvant vaginal brachytherapy (VB) is optional in patients with intermediate risk (IR) and high-intermediate risk (HIR) endometrial cancer (EC). The aim of this French retrospective, multicenter study was to assess the impact of VB in these groups on local recurrence rate, local recurrence-free survival (RFS) and overall survival (OS). METHODS: Data of 191 patients with IR and HIR EC who underwent primary surgery with or without VB and no other adjuvant treatment between 2000 and 2016 were extracted from the FRANCOGYN database. Rate of local recurrence, OS and local RFS in these two groups were compared using the Kaplan-Meier method. RESULTS: The number of patients with IR and HIR EC were 118 and 73 respectively. VB was used in 92 patients in IR group and 43 in HIR group. Median follow-up was 22 months. In the HIR group, the local recurrence rate was significantly higher in the no adjuvant therapy group in comparison with the VB group (16.7% and 0% respectively, p=0.02). There was also a significant improvement in local RFS (p=0.01) in VB group. In IR EC, there is no significant difference on local recurrence rate (4.2% and 3.2%, respectively, p=1.00) or local RFS (p=0.54) between the two groups. CONCLUSIONS: VB is an efficient adjuvant treatment for patients with HIR EC. VB is not associated with an improvement of RFS or OS in IR EC patient.
