Efficiency of radiotherapy plus Anlotinib in alleviating edema and increasing radiosensitivity in symptomatic brain metastasis patients: A retrospective study

Abstract Background: Patients with brain metastases (BM) often suffer from peritumoral edema. The purpose of study was to assess the effect of anlotinib in alleviating peritumoral edema and increasing tumour regression in symptomatic BM patients during radiotherapy. Methods: The volumes of the tumour (Vt), peritumoral edema (Ve) and whole brain (Vb) were delineated based on brain MRI acquired before and after radiotherapy. The regression rates of Vt, Ve and lesion volume (Vl =Vt + Ve) and the regression percentage of Vl in Vb were assessed 1 month after radiotherapy compared with pre-radiotherapy. A multivariate logistic regression analysis was used to analyse the factors related to the regression rates of Vt, Ve and Vl and the regression percentage of Vl in Vb after radiotherapy. Results: A total of 60 BM patients were included, with 14 in the radiotherapy plus anlotinib group and 46 in the radiotherapy alone group. Compared with the radiotherapy alone group, the combined therapy group had a larger regression rate of Vt (75.8% vs. 60.2%, P=0.043), Ve (88.0% vs. 48.0%, P=0.003) and Vl (79.8% vs. 50.5%, P=0.003) and a better regression percentage of Vl in Vb (9.18% vs. 1.57%, P<0.001). Multivariate analysis revealed that radiotherapy plus anlotinib could promote the reduction of Ve (OR=0.104, 95% CI: 0.020-0.544), Vl (OR=0.220, 95% CI: 0.002-0.238), and regression percentage of Vl in Vb (OR=0.030, 95% CI: 0.004-0.256). Conclusion: Concurrent treatment with anlotinib can further reduce peritumoral edema in the early postradiotherapy period for symptomatic BM patients undergoing radiotherapy.