Influence of different initial treatments in prognoses of patients with brain metastases from epidermal growth factor receptor mutations non-small cell lung cancers
10.3760/cma.j.issn.1671-8925.2017.05.012
- VernacularTitle:不同初始治疗方案对EGFR突变非小细胞肺癌脑转移患者预后的影响
- Author:
Xiao LI
1
;
Lijun MA
;
Xiaoju ZHANG
;
Qianqian ZHANG
;
Zheng WANG
;
Jinbing PAN
Author Information
1. 河南省人民医院呼吸与危重症医学科
- Keywords:
Non-small-cell lung cancer;
Brain metastasis;
Simultaneous integrated boost-intensity-modulated radiation therapy;
Targeted therapy
- From:
Chinese Journal of Neuromedicine
2017;16(5):503-507
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacies of upfront simultaneous integrated boost-intensity-modulated radiation therapy (SIB-IMRT) and epidermal growth factor receptor (EGFR) etyrosine kinase inhibitor (TKI) in patients with epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancers who developed brain metastasis (BM).Methods Sixty-eight patients diagnosed as having EGFR-mutant non-small-cell lung cancer developed BM were recruited in our hospital from July 2012 to January 2016.Of these patients,45 received upffont EGFR-TKI gefitinib and 23 accepted SIB-IMRT.The clinical data of these patients were recorded;the viability curve and encephalic progressive cumulative incidence curve were compared between the two groups.Cox multiple-factor analysis was performed to analyze the influencing factors of prognoses.Results The median survival time in the SIB-IMRT group was shorter than that in upfront EGFR-TKI group (18.9 months [95％ CI:16.5-21.4 months] vs.27.5 months [95％CI:21.6-33.5 months]).Log-rank test indicated that the survival rate of patients from SIB-IMRT group was significantly higher than that of patients from EGFR-TKI group (P＜0.05);in the patients from SIB-IMRT group,61％ patients had encephalic progressive changes,with the median survival time of 20.7 months (95％CI:9.6-14.2 months);in the patients from EGFR-TKI group,89％ patients had encephalic progressive changes,with the median survival time of 11.9 months (95％CI:19.7-49.2 months).The encephalic progressive cumulative incidence in patients from EGFR-TKI group was significantly higher than that in patients from SIB-IMRT group (P＜0.05).Multiple-factor analysis indicated that initial therapeutic schedule,prognosis evaluation and extra-cerebral metastasis were the key influencing factors of prognoses.Conclusion The patients accepted upfront EGFR-TKI treatment has longer overall survival and progression free survival than those accepted upfront SIB-IMRT in patients with EGFR-mutant non-small-cell lung cancer who develop BM.
