Timing of Whole Brain Radiotherapy on Survival of Patients withEGFR-mutated Non-small Cell Lung Cancer and Brain Metastases
10.3779/j.issn.1009-3419.2016.08.03
- VernacularTitle:全脑放疗时间对EGFR突变非小细胞肺癌脑转移患者生存的影响
- Author:
LIU GUIMEI
1
;
ZHANG XINYONG
;
TIAN CUIMENG
;
XIA GUANGRONG
;
LIU PING
;
ZHANG QUAN
;
LI XI
;
ZHANG HUI
;
QIN NA
;
WANG JINGHUI
;
ZHANG SHUCAI
Author Information
1. 101149 北京，首都医科大学附属北京胸科医院，北京市结核病胸部肿瘤研究所放疗科
- Keywords:
Whole brain radiotherapy;
Tyrosine kinase inhibitors;
Epidermal growth factor receptor mutation;
Lung neoplasms;
Brain metastasis
- From:
Chinese Journal of Lung Cancer
2016;19(8):501-507
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective hTere is no high-level evidence for the time of whole brain radiotherapy (WBRT) for patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) and brain metastases. hTe aim of this study is to assess the appropriate timing of WBRT for patients withEGFR-mutated NSCLC and brain metastases (BM).Methods hTere were 78 patients diagnosed withEGFR-mutated NSCLC and BM in Beijing Chest Hospital between August 2009 and May 2015. 48 untreated patients who received both WBRT and EGFR-tyrosine kinase inhibitors (TKIs) therapy. Prognostic factors of intracranial progression-free survival (PFS) and overall survival (OS) were identiifed byCox proportional hazards modeling.Results Intracranial objective response rate was 81.3% and disease control rate was 93.8%. Median intracranial PFS was 10 months. Median OS was 18 months. Multivariate analysis of intracranial PFS revealed that Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 (HR=30.436, 95%CI: 4.721-196.211, P<0.001) and early WBRT (HR=3.663, 95%CI: 1.657-8.098,P=0.001) had a better intracranial PFS. Multivariate analysis of OS revealed that PS 0-1 (HR=57.607, 95%CI: 6.135-540.953,P<0.001), early WBRT (HR=2.757, 95%CI: 1.140-6.669,P=0.024), and stereotactic radiosurgery (HR=5.964, 95%CI: 1.895-18.767,P=0.002) were independent prognostic factors of OS.Conclusion Early WBRT combined with EGFR-TKIs can improve outcomes of patients withEGFR-mutated NSCLC and BM, but it needs to be conifrmed by large-sample-size and multicenter prospective clinical trials.
