EGFR Mutation Is Associated with Short Progression-Free Survival in Patients with Stage III Non-squamous Cell Lung Cancer Treated with Concurrent Chemoradiotherapy
- Author:
Song Ee PARK
1
;
Jae Myoung NOH
;
You Jin KIM
;
Han Sang LEE
;
Jang Ho CHO
;
Sung Won LIM
;
Yong Chan AHN
;
Hongryull PYO
;
Yoon La CHOI
;
Joungho HAN
;
Jong Mu SUN
;
Se Hoon LEE
;
Jin Seok AHN
;
Keunchil PARK
;
Myung Ju AHN
Author Information
- Publication Type:Original Article
- Keywords: Non-squamous non-small cell lung cancer; Chemoradiotherapy; Stage III; EGFR mutation; Survival
- MeSH: Brain; Carcinoma, Non-Small-Cell Lung; Chemoradiotherapy; Disease Progression; Disease-Free Survival; Epithelial Cells; Erlotinib Hydrochloride; Follow-Up Studies; Humans; Lung Neoplasms; Lung; Male; Medical Records; Neoplasm Metastasis; Protein-Tyrosine Kinases; Receptor, Epidermal Growth Factor
- From:Cancer Research and Treatment 2019;51(2):493-501
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: This study was conducted to evaluate the relationship between epidermal growth factor receptor (EGFR) mutation and clinical outcomes in patients with stage III non-squamous cell lung cancer treated with definitive concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS: From January 2008 to December 2013, the medical records of 197 patients with stage III non- squamous non-small cell lung cancer treated with definitive CCRT were analyzed to determine progression-free survival (PFS) and overall survival (OS) according to EGFR mutation status. RESULTS: Among 197 eligible patients, 81 patients were EGFR wild type, 36 patients had an EGFR mutation (exon 19 Del, n=18; L858R, n=9, uncommon [G719X, L868, T790M], n=9), and 80 patients had unknown EGFR status. The median age was 59 years (range, 28 to 80 years) and 136 patients (69.0%) were male. The median follow-up duration was 66.5 months (range, 1.9 to 114.5 months). One hundred sixty-four patients (83.2%) experienced disease progression. Median PFS was 8.9 months for the EGFR mutation group, 11.8 months for EGFR wild type, and 10.5 months for the unknown EGFR group (p=0.013 and p=0.042, respectively). The most common site of metastasis in the EGFR mutant group was the brain. However, there was no significant difference in OS among the three groups (34.6 months for EGFR mutant group vs. 31.9 months for EGFR wild type vs. 22.6 months for EGFR unknown group; p=0.792 and p=0.284). A total of 29 patients (80.6%) with EGFR mutation were treated with EGFR tyrosine kinase inhibitor (gefitinib, n=24; erlotinib, n=3; afatinib, n=2) upon progression. CONCLUSION: EGFR mutation is associatedwith short PFS and the brain is the most common site of distant metastasis in patients with stage III non- squamous cell lung cancer treated with CCRT.
