Incidence, features and management of radionecrosis in melanoma patients treated with cerebral radiotherapy and anti‐PD‐1 antibodies
| العنوان: | Incidence, features and management of radionecrosis in melanoma patients treated with cerebral radiotherapy and anti‐PD‐1 antibodies |
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| المؤلفون: | Zeynep Eroglu, Lauren E. Haydu, George D. Grass, Robert M. Conry, Jessica L. Smith, Simone M. Goldinger, Mark Shackleton, Matteo S. Carlino, Ashlyn S. Everett, Isabella C. Glitza, Douglas B. Johnson, Rachel Roberts-Thomson, Romany A. N. Johnpulle, Peter Koelblinger, Alexander Guminski, Serigne Lo, Georgina V. Long, Rony Kapoor, Ines Pires da Silva, Patricia Banks, Victoria Atkinson, Wei Wang, Alexander M. Menzies, Michael Millward, Angela Hong |
| المصدر: | Pigment Cell Melanoma Res |
| بيانات النشر: | Wiley, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, 0301 basic medicine, medicine.medical_specialty, Bevacizumab, medicine.medical_treatment, Programmed Cell Death 1 Receptor, Ipilimumab, Dermatology, Antibodies, Article, General Biochemistry, Genetics and Molecular Biology, Cohort Studies, Necrosis, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, medicine, Humans, Cumulative incidence, Radiation Injuries, Melanoma, business.industry, Incidence, Incidence (epidemiology), Brain, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Survival Analysis, Radiation therapy, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, Multivariate Analysis, Cohort, Female, Neurosurgery, Radiology, business, medicine.drug |
| الوصف: | BACKGROUND: Brain radiotherapy is used in the management of melanoma brain metastases (MBM) and can result in radionecrosis. Anti-PD-1 is active in the brain and may increase the risk of radionecrosis when combined with radiotherapy. We studied the incidence, associated factors and management of radionecrosis in longer-term survivors with MBM treated with this combination. METHODS: Patients with MBM treated with radiotherapy and anti-PD-1 who survived >1 year were identified to determine radionecrosis incidence (Cohort A, n = 135). Cohort A plus additional radionecrosis cases were examined for factors associated with radionecrosis and management (Cohort B, n = 148). RESULTS: From Cohort A, 17% developed radionecrosis, with a cumulative incidence at 2 years of 18%. Using Cohort B, multivariable analysis confirmed an association between radionecrosis and elevated lactate dehydrogenase (p = 0.0496) and prior treatment with ipilimumab (p = 0.0319). Radionecrosis was diagnosed based on MRI (100%), symptoms (69%) and pathology (56%). Treatment included corticosteroids, bevacizumab and neurosurgery. CONCLUSIONS: Radionecrosis is a significant toxicity in longer-term melanoma survivors with MBM treated with anti-PD-1 and radiotherapy. Identification of those at risk of radionecrosis who may avoid radiotherapy is required. |
| تدمد: | 1755-148X 1755-1471 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::04f18946bddd2aec8b60a7eecf640116Test https://doi.org/10.1111/pcmr.12775Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....04f18946bddd2aec8b60a7eecf640116 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 1755148X 17551471 |
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