放射治疗（RT）可引起靶向病灶以及放射范围外病变的消退现象称为离骚效应，该效应被认为是通过免疫学机制引起的。在晚期黑色素瘤和非小细胞肺癌（NSCLC）的脑转移中，全脑放射（WBRT）和立体定向放射外科手术（SRS）后已描述这种现象。我们系统地回顾了现有文献，以确定哪种放射治疗模式和免疫治疗（IT）组合可能引起离骚效应，确定RT和IT的最佳时机，并确定与RT和IT组合相关的潜在不良反应。使用PRISMA准则，搜索PubMed、Medline和Web of Science，以识别在治疗NSCLC或黑色素瘤的BM期间表现出离骚效应的研究。在18项符合纳入标准的研究中，对598例黑色素瘤或NSCLC辐射性脑转移进行了评估。PD-1或CTLA-4免疫检查点抑制剂（ICI）是最常用的IT。RT在ICI之后的3个月内最常被应用。16项研究描述了ICI和RT之间的协同作用，包括在照射区域内外的肿瘤反应更强的证据。在12篇文章中（n = 232患者）报道了在接受RT和系统IT同时治疗的BM患者的客观反应率（ORR），非加权平均ORR为49.4％。在5篇文章中（n = 110患者）报告的RT或IT单独治疗的ORR为27.8％。没有研究发现接受RT和ICI的患者出现明显的毒性增加。RT和ICI的结合可能增强ICI的疗效，并通过离骚效应在黑色素瘤或NSCLC的脑转移患者中诱发更持久的响应。© 2023年作者（独家许可）Springer Science+Business Media、LLC的一部分。

The phenomenon of radiation therapy (RT) causing regression of targeted lesions as well as lesions outside of the radiation field is known as the abscopal effect and is thought to be mediated by immunologic causes. This phenomena has been described following whole brain radiation (WBRT) and stereotactic radiosurgery (SRS) of brain metastasis (BM) in advanced melanoma and non-small-cell lung cancer (NSCLC). We systematically reviewed the available literature to identify which radiation modality and immunotherapy (IT) combination may elicit the abscopal effect, the optimal timing of RT and IT, and potential adverse effects inherent to the combination of RT and IT.Using PRISMA guidelines, a search of PubMed, Medline, and Web of Science was conducted to identify studies demonstrating the abscopal effect during treatment of NSCLC or melanoma with BM.598 cases of irradiated BM of melanoma or NSCLC in 18 studies met inclusion criteria. The most commonly administered ITs included PD-1 or CTLA-4 immune checkpoint inhibitors (ICI), with RT most commonly administered within 3 months of ICI. Synergy between ICI and RT was described in 16 studies including evidence of higher tumor response within and outside of the irradiated field. In the 12 papers (n = 232 patients) that reported objective response rate (ORR) in patients with BM treated with RT and concurrent systemic IT, the non-weighted mean ORR was 49.4%; in the 5 papers (n = 110 patients) that reported ORR for treatment with RT or IT alone, the non-weighted mean ORR was 27.8%. No studies found evidence of significantly increased toxicity in patients receiving RT and ICI.The combination of RT and ICIs may enhance ICI efficacy and induce more durable responses via the abscopal effect in patients with brain metastases of melanoma or NSCLC.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.