ArticleTranslational oncology2026
Radiotherapy and immunotherapy for advanced cancers: A meta-analysis of dose, sequencing, and survival patterns.
Article in Translational oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
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4 authors.
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Abstract
backgroundCombining radiotherapy (RT) with immune checkpoint inhibitors (ICIs) offers potential synergy through RT-induced immunogenic cell death and enhanced systemic immunity. However, optimal RT dose, fractionation, and sequencing with ICIs remain unresolved. This meta-analysis evaluates the impact of biologically effective dose (BED), treatment timing, and ICI agents on progression-free survival (PFS) and safety in advanced cancers.
methodsA systematic search of PubMed, Embase, Web of Science, and Cochrane Library (2010-2024) identified 18 studies (727 patients). Pooled PFS and treatment-related adverse events (TRAEs) were analyzed using random-effects models. Subgroup analyses stratified outcomes by cancer type, RT regimen, BED (low: ≤50; moderate: 50-100; high: >100), treatment sequence (concurrent/sequential), and ICI agents. This study was registered on PROSPERO (CRD420251044176).
resultsThe synthesis of PFS revealed extreme between study heterogeneity, with a wide 95% prediction interval ranging from 0.90 to 41.21 months. Despite this variance, reconstructed individual patient data suggested that moderate BED regimens between 50 and 100 showed a more favorable median PFS compared to low or high dose regimens. Concurrent administration of radiotherapy and immunotherapy demonstrated a longer reconstructed median PFS than sequential strategies. Furthermore, PD-1 and PD-L1 based regimens appeared to perform better than CTLA-4-only approaches. The pooled incidence of grade 3 or higher TRAEs was 0.22, indicating a manageable overall safety profile.
conclusionThis descriptive meta-analysis and reconstructed individual patient data synthesis provide hypothesis-generating insights into combined radioimmunotherapy. Concurrent administration of moderate BED radiotherapy with PD-1 and PD-L1 inhibitors suggests a plausible balance of efficacy and safety. However, extreme heterogeneity limits direct clinical application, underscoring the critical need for standardized dose protocols and rigorous sequencing in future randomized trials.
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