Stereotactic body radiotherapy combined with immunotherapy: a systematic review focus on timing and toxicity profile

作者：Cattaneo CG, Chiloiro G, Romano A, Panza G, Galetto M, Nardini M, Placidi L, Gambacorta MA, Boldrini L · 发表于：Technical innovations & patient support in radiation oncology · 年份：2026 · DOI：10.1016/j.tipsro.2026.100399 · 被引用次数：44

BACKGROUND: The combination of Stereotactic Body Radiotherapy (SBRT) with immune checkpoint inhibitors (ICIs) has gained increasing interest due to its potential to enhance antitumor immune responses. However, the optimal timing, dose, and safety profile of this combined approach remain unclear, and available clinical evidence is highly heterogeneous. METHODS: A systematic review of the literature was conducted in accordance with PRISMA guidelines. PubMed/MEDLINE, Embase, and Cochrane Library databases were searched for clinical studies evaluating the combination of SBRT and ICIs. Studies were included if they reported toxicity outcomes and involved patients with solid tumors treated with SBRT in combination with ICIs. Data on study design, patient characteristics, SBRT dose and fractionation, treatment sequencing, and treatment-related toxicities were extracted and qualitatively analyzed. RESULTS: A total of 31 clinical studies met the inclusion criteria, encompassing 2,355 patients across multiple tumor types, including non-small cell lung cancer, melanoma, breast cancer, renal cell carcinoma, prostate cancer, hepatocellular carcinoma, and pancreatic or biliary malignancies. Fifteen studies employed concurrent SBRT-ICI administration, 13 adopted a sequential approach, and 3 included both strategies. SBRT dose and fractionation were highly variable, ranging from palliative regimens to ablative schedules, with reported BED10 values spanning approximately 43-113 Gy; detailed...