Application of Low-Dose Radiotherapy Combined with Immunotherapy for Drug-Resistant Hepatic Metastasis: a Case Series Analysis.
5 affiliations
- 1Radiotherapy Department, The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, 712000, China.
- 2Department of Radiation Oncology, The First Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, China.
- 3Oncology Department, The Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine, Xianyang, Shaanxi, 712000, China.
- 4Department of Staff Healthcare, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310000, China.
- 5Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China.
Abstract
Objectives
There is no established standard regimen for end-stage patients suffering from multi-line refractory diffuse hepatic metastases. This case series intended to assess the antitumor activity, treatment tolerance and palliative value of whole-liver low-dose radiotherapy combined with PD-1 immunotherapy, with special attention paid to the occurrence of systemic abscopal effect.Patients and methods
This retrospective case series aimed to evaluate the clinical efficacy and safety of low-dose whole-liver radiotherapy (LDRT) combined with PD-1 inhibitor immunotherapy in patients with refractory diffuse hepatic metastases from solid tumors. Six patients who developed progressive diffuse hepatic metastases after one or more lines of prior systemic therapy and subsequently received LDRT plus immunotherapy were enrolled. All patients were followed up until the predefined cutoff date of July 2026. The primary endpoints were objective response rate (ORR) and the incidence of treatment-related adverse events (TRAEs). The secondary endpoints included symptomatic improvement and changes in quality of life. Tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and adverse events were graded based on the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. All enrolled patients presented with extensive diffuse intrahepatic metastasis at baseline.Results
With a median follow-up of 7.5 months, tumor regression or radiological remission was observed in several patients,yielding an objective response rate (ORR) of 66.7%. Clinical symptomatic relief and improved quality of life were achieved in four patients after combination treatment. In terms of safety, No grade 3 or higher TRAEs definitively attributable to this combined regimen were observed during treatment.The combined regimen appeared to be generally tolerable for the liver. Collectively, these preliminary findings suggest a potential clinical benefit and acceptable safety of this LDRT plus immunotherapy combination in one or more lines pretreated patients with diffuse hepatic metastases.Conclusion
This exploratory case-series generates the hypothesis that low-dose radiotherapy combined with immunotherapy may yield clinical benefits for selected patients with diffuse treatment-refractory hepatic metastases. Further prospective clinical trials and translational research are warranted to elucidate the underlying immunomodulatory mechanisms and define patient subsets most likely to derive clinical benefit from this approach.
Related
- Case Report: Low-dose radiotherapy as part of multimodal salvage therapy for immunotherapy-resistant SMARCA4-deficient non-small cell lung cancer.
- Exploring immunotherapy resistance in bone metastasis: mechanisms and optimization of combined treatment strategies-a narrative review.
- Association between absolute lymphocyte count and outcomes of radiotherapy combined with immunotherapy in elderly patients with inoperable esophageal squamous cell carcinoma
- Safety of neoadjuvant radiotherapy or chemoradiotherapy combined with immunotherapy across solid tumors: Systematic review and meta-analysis protocol
- Spontaneous Pneumothorax During Stereotactic Body Radiotherapy for Pulmonary Metastasis From Osteosarcoma: A Case Report and Literature Review
BibTeX
@article{liang2026application,
title = {{Application of Low-Dose Radiotherapy Combined with Immunotherapy for Drug-Resistant Hepatic Metastasis: a Case Series Analysis.}},
author = {Gege Liang and Bo Lyu and Cuicui Geng and Yiru Han and Yang Guo and Lu Zhang and Lizhe Sun},
journal = {Clinical and translational radiation oncology},
year = {2026},
month = oct,
doi = {10.1016/j.ctro.2026.101323},
url = {https://europepmc.org/article/MED/42910005},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Application of Low-Dose Radiotherapy Combined with Immunotherapy for Drug-Resistant Hepatic Metastasis: a Case Series Analysis.
AU - Gege Liang
AU - Bo Lyu
AU - Cuicui Geng
AU - Yiru Han
AU - Yang Guo
AU - Lu Zhang
AU - Lizhe Sun
PY - 2026
DA - 2026/10/12
JO - Clinical and translational radiation oncology
DO - 10.1016/j.ctro.2026.101323
UR - https://europepmc.org/article/MED/42910005
AB - Objectives There is no established standard regimen for end-stage patients suffering from multi-line refractory diffuse hepatic metastases. This case series intended to assess the antitumor activity, treatment tolerance and palliative value of whole-liver low-dose radiotherapy combined with PD-1 immunotherapy, with special attention paid to the occurrence of systemic abscopal effect.Patients and methods This retrospective case series aimed to evaluate the clinical efficacy and safety of low-dose whole-liver radiotherapy (LDRT) combined with PD-1 inhibitor immunotherapy in patients with refractory diffuse hepatic metastases from solid tumors. Six patients who developed progressive diffuse hepatic metastases after one or more lines of prior systemic therapy and subsequently received LDRT plus immunotherapy were enrolled. All patients were followed up until the predefined cutoff date of July 2026. The primary endpoints were objective response rate (ORR) and the incidence of treatment-related adverse events (TRAEs). The secondary endpoints included symptomatic improvement and changes in quality of life. Tumor response was assessed according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, and adverse events were graded based on the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. All enrolled patients presented with extensive diffuse intrahepatic metastasis at baseline.Results With a median follow-up of 7.5 months, tumor regression or radiological remission was observed in several patients,yielding an objective response rate (ORR) of 66.7%. Clinical symptomatic relief and improved quality of life were achieved in four patients after combination treatment. In terms of safety, No grade 3 or higher TRAEs definitively attributable to this combined regimen were observed during treatment.The combined regimen appeared to be generally tolerable for the liver. Collectively, these preliminary findings suggest a potential clinical benefit and acceptable safety of this LDRT plus immunotherapy combination in one or more lines pretreated patients with diffuse hepatic metastases.Conclusion This exploratory case-series generates the hypothesis that low-dose radiotherapy combined with immunotherapy may yield clinical benefits for selected patients with diffuse treatment-refractory hepatic metastases. Further prospective clinical trials and translational research are warranted to elucidate the underlying immunomodulatory mechanisms and define patient subsets most likely to derive clinical benefit from this approach.
SN - 2405-6308
ER -