OncoTargets and therapy · 2026
Efficacy and Safety of Low-Dose Hypofractionated Radiotherapy Combined with Immunotherapy for Liver Metastases: A Single-Center Retrospective Analysis.
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Qin Lanqun, Wei Yanshuang, Tao Li, Jiang Hua, Qian Danping, Geng Qian, Li Dongqing
Аннотация
OBJECTIVE: To evaluate the efficacy and safety of low-dose hypofractionated radiotherapy (LDHRT) for liver metastases when combined with immunotherapy.
METHODS: Patients with liver metastases receiving immunotherapy were enrolled in this study at Changzhou Second People's Hospital from January 2019 to May 2025 (Ethics Approval No. [2021]KY117-01). LDHRT (12 Gy in 3 fractions) was administered to the liver metastases using volumetric modulated arc therapy (VMAT). The tumor response was evaluated according to the RECIST 1.1 standard. Clinical and imaging data were collected to assess changes in tumors inside and outside the radiation field before and after LDHRT, as well as the median progression-free survival (PFS) for lesions within the radiation field.
RESULTS: A total of 51 patients were included, with the median age of 69 (range 47-84) years; 86.3% (44/51) were male, and 94.1% (48/51) had an ECOG performance status (PS) score ≥1. Additionally, 54.9% (28/51) had received ≥3 lines of prior therapy. Due to the continuous progression of liver metastases under systemic treatment, LDHRT was administered for the liver metastases. The study found a high local control rate within the radiation field as the objective response rate (ORR) and disease control rate (DCR) within the radiation field were 17.6% and 86.3%, respectively. However, the efficacy for lesions outside the radiation field was significantly inferior, with an ORR of 0% and a DCR of 35.3%. The median PFS for lesions within the radiation field was 4.23 months. Patients with colorectal liver metastases (CRLM) showed better PFS than those with gastric cancer liver metastases (GCLM). The most common adverse events were fatigue (16/51, 31.4%), abnormal liver function (11/51, 21.6%), and hypothyroidism (7/51, 13.7%). No patients discontinued treatment due to treatment-related adverse events.
CONCLUSION: LDHRT combined with immunotherapy provided favorable local control and was generally well tolerated in patients with liver metastases. No apparent abscopal effect was observed, suggesting that single-lesion LDHRT was insufficient to reverse systemic immunosuppression.
METHODS: Patients with liver metastases receiving immunotherapy were enrolled in this study at Changzhou Second People's Hospital from January 2019 to May 2025 (Ethics Approval No. [2021]KY117-01). LDHRT (12 Gy in 3 fractions) was administered to the liver metastases using volumetric modulated arc therapy (VMAT). The tumor response was evaluated according to the RECIST 1.1 standard. Clinical and imaging data were collected to assess changes in tumors inside and outside the radiation field before and after LDHRT, as well as the median progression-free survival (PFS) for lesions within the radiation field.
RESULTS: A total of 51 patients were included, with the median age of 69 (range 47-84) years; 86.3% (44/51) were male, and 94.1% (48/51) had an ECOG performance status (PS) score ≥1. Additionally, 54.9% (28/51) had received ≥3 lines of prior therapy. Due to the continuous progression of liver metastases under systemic treatment, LDHRT was administered for the liver metastases. The study found a high local control rate within the radiation field as the objective response rate (ORR) and disease control rate (DCR) within the radiation field were 17.6% and 86.3%, respectively. However, the efficacy for lesions outside the radiation field was significantly inferior, with an ORR of 0% and a DCR of 35.3%. The median PFS for lesions within the radiation field was 4.23 months. Patients with colorectal liver metastases (CRLM) showed better PFS than those with gastric cancer liver metastases (GCLM). The most common adverse events were fatigue (16/51, 31.4%), abnormal liver function (11/51, 21.6%), and hypothyroidism (7/51, 13.7%). No patients discontinued treatment due to treatment-related adverse events.
CONCLUSION: LDHRT combined with immunotherapy provided favorable local control and was generally well tolerated in patients with liver metastases. No apparent abscopal effect was observed, suggesting that single-lesion LDHRT was insufficient to reverse systemic immunosuppression.