{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T07:19:36Z","timestamp":1787901576833,"version":"build-2784847793"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the efficacy and safety of concurrent versus sequential stereotactic radiotherapy (SRT) and immune checkpoint inhibitors (ICIs) in non\u2010small cell lung cancer (NSCLC) patients with multiple brain metastases (BM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 198 NSCLC patients with BM who underwent SRT and ICIs treatment between 2017 and 2024. Of 136 eligible patients, were assigned to two cohorts and subcohorts through propensity score matching. The concurrent cohort consisted of 68 patients receiving ICIs within 14\u2009days of SRT (post\u2010SRT 34 cases and pre\u2010SRT 34 cases). The sequential cohort included another 68 patients undergoing sequential treatment &gt;\u200914\u2009days apart (post\u2010SRT1 31 cases and pre\u2010SRT1 37 cases). Overall survival (OS) and intracranial progression\u2010free survival (iPFS) were the primary endpoints. Secondary endpoints were intracranial objective response rate (iORR), disease control rate (DCR) and adverse events (AEs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Concurrent group achieved significantly superior median OS (24.5\u2009months vs. 18.3\u2009months, HR\u2009=\u20090.68, 95% CI 0.49\u20130.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and median iPFS (14.2\u2009months vs. 9.8\u2009months, HR\u2009=\u20090.62, 95% CI 0.45\u20130.86,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) compared to the sequential group. Subgroup analysis, the post\u2010SRT group showed significantly improved median OS (27.1\u2009months vs. 17.2, 19.2, 13.2\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and median iPFS (20.1\u2009months vs. 10.5, 12.1, 5.3\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) compared to the other three groups (pre\u2010SRT, post\u2010SRT1 and pre\u2010SRT1). Multivariate analysis revealed that a treatment interval\u2009\u2264\u200914\u2009days was an independent protective factor for both iPFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004) and OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019). Subgroup analysis demonstrated that a treatment interval \u2264\u20097\u2009days was superior to an interval of 8\u201314\u2009days or\u2009&gt;\u200914\u2009days. Furthermore, ICIs following SRT was associated with improved OS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and iPFS (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). No significant differences were observed in radionecrosis (RN) and AEs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Concurrent SRT with ICI, especially ICIs following SRT, provides superior survival outcomes for NSCLC patients with multiple BM, without increasing AEs. The timing of therapy is a critical factor influencing the efficacy of the combined regimen.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.71105","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:33:42Z","timestamp":1787726022000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concurrent Stereotactic Radiotherapy and Immune Checkpoint Inhibitors for Multiple Brain Metastases in Non\u2010Small Cell Lung Cancer \u2010 A Multi\u2010Center Retrospective Analysis"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5970-1835","authenticated-orcid":false,"given":"Xiaoliang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Radiotherapy The Third Hospital of Zhangzhou  Zhangzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The Third Hospital of Zhangzhou  Zhangzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Oncology The Third Hospital of Zhangzhou  Zhangzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The Third Hospital of Zhangzhou  Zhangzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Guan","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy The Third Hospital of Zhangzhou  Zhangzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Oncology The Third Hospital of Zhangzhou  Zhangzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiali","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Oncology The Third Hospital of Zhangzhou  Zhangzhou Fujian China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2020.10.014"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201091863\u20107"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1220047"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.3779\/j.issn.1009\u20103419.2024.102.42"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr\u201024\u2010132"},{"key":"e_1_2_14_7_1","unstructured":"European Society for Radiotherapy and Oncology (ESTRO) \u201cESTRO 2024 Abstract Book. 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