Background: This study aimed to evaluate the differences in common types of epidermal growthfactor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) with brain metastasis (BM) treated using linear accelerator-based stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (fSRT). Methods: Between January 2011–December 2023, among 294 consecutive patients with BMfrom NSCLC, 84 patients with EGFR-mutated NSCLC were enrolled in this study. Results: The median follow-up time after SRS/fSRT was 20.1 months (range: 0.6–109.7months), while the median overall survival (mOS) after SRS/fSRT was 25.1 months (95% confidence interval [CI]: 18.4–33.5 months). The mOS after initial treatment for NSCLC was 56.2 months (95% CI:41.7–77.0 months). The mOS after SRS/fSRT in 34 patients with exon 19 deletions and 45 patients with exon 21 mutations with L858R was 20.4 months (95% CI: 13.6–55.9 months) and 28.5 months (95% CI: 16.2–33.5). The two groups showed no difference in the mOS. In univariate analyses using the Cox proportional hazards model, no prognostic factors associated with prolonged survival were identified except for good pretreatment Karnofsky Performance Status score and no prior tyrosine kinase inhibitor use before SRS/fSRT in EGFR-mutated NSCLC. There was no difference in both distant failure and local control in the two groups. Conclusion The difference in survival between EGFR subtypes (exon 21 L858R mutations vs.exon 19 deletion) was not observed after SRS/fSRT in NSCLC.

OBJECTIVE: To evaluate the efficacy and toxicity of paclitaxel plus carboplatin (TC)-based concurrent chemoradiotherapy (CCRT) followed by consolidation chemotherapy in the International Federation of Gynecology and Obstetrics (FIGO) stage IIIB/IVA cervical cancer patients. METHODS: We reviewed the medical records of FIGO stage IIIB/IVA cervical cancer patients (n=30) who had been intended to be treated with TC-based CCRT followed by consolidation chemotherapy (TC-CCRT-group) from April 2012–May 2016. Patients who had been treated with CCRT involving a single platinum agent (CCRT-group; n=52) or definitive radiotherapy alone (RT-group; n=74) from January 1997–September 2012 were also identified and used as historical controls. Survival was calculated using the Kaplan-Meier method and compared using the log-rank test. RESULTS: Of the 30 patients included in the TC-CCRT-group, 22 patients (73.3%) completed the planned TC-based CCRT. The most frequently observed acute grade 3/4 hematological toxicities were leukopenia and neutropenia, and diarrhea was the most common acute grade 3/4 non-hematological toxicity. After a median follow-up of 35 months, 9 patients (30.0%) had developed recurrent disease. The patients' estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 67.9% and 90.8%, respectively. In comparisons with historical control groups, the survival outcomes of TC-CCRT-group was significantly superior to CCRT-group in terms of OS (p=0.011) and significantly superior to RT-group in terms of both PFS (p=0.009) and OS (p<0.001). CONCLUSION: TC-based CCRT followed by consolidation chemotherapy is safe and effective. A randomized controlled study needs to be conducted to further evaluate the efficacy of this multimodal approach in this patient population.
Carboplatin* ; Chemoradiotherapy* ; Consolidation Chemotherapy* ; Diarrhea ; Disease-Free Survival ; Follow-Up Studies ; Gynecology ; Humans ; Leukopenia ; Medical Records ; Methods ; Neutropenia ; Obstetrics ; Paclitaxel* ; Platinum ; Prognosis ; Radiotherapy ; Uterine Cervical Neoplasms*