Cerebral small vessel disease as a possibly immune-related adverse event of immunotherapy in lung cancer patients: a retrospective study.

Background: This clinical study aims to investigate the incidence of cerebral small vessel disease (CSVD) in lung cancer patients treated with ICIs and to analyze its risk factors by comparing the clinical features and laboratory tests in ICIs-treated lung cancer patients with or without CSVD. Methods: This retrospective study included 400 hospitalized patients from January 2018 to May 2024. All patients had confirmed lung cancer, received at least one cycle of ICIs, and underwent cranial MR imaging before and after ICIs treatment. Information from the medical records, including clinical features, MR imaging findings, laboratory tests, complications, treatment, and clinical outcomes, was extracted for analysis. Results: 104 (26%) patients with CSVD were confirmed and 53.25% were aged≥65 years. Risk factors identified as independent predictors of CSVD included age (OR, 1.03), stage IV (OR, 2.87), and hyperlipidemia (OR, 1.02). In the CSVD group, FT Conclusion: This study found that CSVD may be a related adverse event of immunotherapy in lung cancer patients. In addition to age≥65 years, hyperlipidemia and stage IV, hypothyroidism, elevated cysteine C levels, and elevated systemic inflammatory markers such as PLR and SII were further associated with an increased risk of CSVD.