放射治疗是脑转移瘤（BM）的标准治疗方法之一。在过去的几年里，免疫疗法作为实体瘤的常规治疗的引入迫使研究人员审查和评估它如何与放射相互作用。放射和免疫疗法显示出协同作用，可以激活宿主的免疫系统并增强治疗反应。目前正在研究对 BM 的组合效应。已对 Pubmed 上发表的数据进行了审查，以确定放疗和免疫疗法联合治疗 BM 的毒性、生存率、治疗特征和时机。大多数回顾性审查报告颅内无进展情况有所改善BM 患者联合放射免疫治疗时的生存率 (iPFS)。两项系统评价和荟萃分析以及一项 II 期前瞻性试验也报告了 iPFS 的益处，且不会增加毒性。在已发表的文献中，并发的定义是不同的，一个月甚至缩小的间隔与更好的临床结果相关。同步放射免疫治疗引起的毒性，特别是有症状的放射性坏死，也被直接分析并报告为较低，类似于单独立体定向放射外科的继发毒性率。在主要回顾性评论中，放射与免疫治疗相结合显示出对 BM 治疗的协同作用。放射免疫疗法的同步组合是一种可行的治疗策略，并且在 30 天内实施时似乎可以改善临床结果，尤其是 iPFS。需要更大规模的前瞻性和随机研究来建立可靠的结果、最佳给药策略和毒性概况。版权所有 © 2023 Antelo、Comas、Casas、Valduvieco、Barreto、Laplana、Mases、Oses 和 Mollà。

Radiotherapy is one of the standard treatments for brain metastases (BM). Over the past years, the introduction of immunotherapy as routine treatment for solid tumors has forced investigators to review and evaluate how it would interact with radiation. Radiation and Immunotherapy have shown a synergic effect activating the host's immune system and enhancing treatment response. The combinatory effect on BM is currently under investigation.Data published on Pubmed to determine toxicity, survival, treatment characteristics and timing on the combination of radiotherapy and immunotherapy for the treatment of BM has been reviewed.Mostly retrospective reviews report an improvement of intracranial progression free survival (iPFS) when combining radioimmunotherapy for BM patients. Two systematic reviews and meta-analysis and one phase II prospective trial also report a benefit on iPFS without an increase of toxicity. Among the published literature, the definition of concurrency is heterogeneous, being one month or even narrowed intervals correlated to better clinical outcomes. Toxicity due to concurrent radioimmunotherapy, specifically symptomatic radionecrosis, is also directly analyzed and reported to be low, similar to the toxicity rates secondary to stereotactic radiosurgery alone.Radiation combined with immunotherapy has shown in predominantly retrospective reviews a synergic effect on the treatment of BM. The concurrent combination of radioimmunotherapy is a feasible therapeutic strategy and seems to improve clinical outcomes, especially iPFS, when delivered within <30 days. Larger prospective and randomized studies are needed to establish reliable outcomes, best delivery strategies and toxicity profile.Copyright © 2023 Antelo, Comas, Casas, Valduvieco, Barreto, Laplana, Mases, Oses and Mollà.