Timing of Brain Radiation Therapy Impacts Outcomes in Patients with Non-small Cell Lung Cancer Who Develop Brain Metastases
10.3779/j.issn.1009-3419.2016.08.04
- VernacularTitle:非小细胞肺癌脑转移放疗时机的选择及疗效预后分析
- Author:
WANG YANG
1
;
FANG JIAN
;
NIE JUN
;
DAI LING
;
HU WEIHENG
;
ZHANG JIE
;
MA XIANGJUAN
;
HAN JINDI
;
CHEN XIAOLING
;
TIAN GUANGMING
;
WU DI
;
HAN SEN
;
LONG JIERAN
Author Information
1. 100142北京，北京大学肿瘤医院暨北京市肿瘤防治研究所，恶性肿瘤发病机制及转化研究教育部重点实验室，胸部肿瘤内二科
- Keywords:
Lung neoplasms;
Brain metastases;
Brain radiotherapy;
Chemotherapy;
Targeted therapy
- From:
Chinese Journal of Lung Cancer
2016;19(8):508-514
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). hTe aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes.Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemo-therapy or targeted therapy) were identiifed. hTe rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no signiifcant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease speciifc-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group.Results Me-dian overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 monthsvs 12.6 months;P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 monthsvs 3.0 months;P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy atfer the diagnosis of brain metastases as any line therapy improved the OS (20.0 monthsvs 10.7 months;P<0.01), whereas receiving TKI as ifrst line therapy did not (17.9 monthsvs 15.2 months;P=0.289).Conclusion Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospec-tive multi-central randomized study is imminently needed.
