Efficacy of brain radiotherapy plus EGFR-TKI for EGFR-mutated NSCLC patients who develop brain metastasis
Introduction:To analyze the appropriate treatment methods or timing to use of EGFR tyrosine kinase inhibitors(TKIs)and brain radiation treatment(RT)for symptomatic and asymptomatic brain metastases(BM)in patients with epidermal growth factor receptor(EGFR)mutation NSCLC.Material and methods:We retrospectively studied patients diagnosed with EGFR gene mutated NSCLC who develop brain metastasis from June 2006 to December 2015 at Zhejiang Cancer Hospital.Treatment data had been assessed in 181 patients of 49 symptomatic BM and 132 asymptomatic BM retrospectively.Results:In 49 symptomatic BM patients,the median OS of using SRS group was longer than in WBRT group(37.7 vs 21.1 months)(P=0.194).In the group of 132 asymptomatic brain metastasis patients,the mOS was longer in upfront brain radiotherapy compared with the upfront TKI group(24.9 vs 17.4 months)(P=0.035).Further analysis to the timing of using radiotherapy,all 74 patients,33 were underwent concurrent TKI and brain radiation,13 received TKI after first-line RT treatment and 28 patients received radiotherapy after TKI failure.The iPFS of three groups was 11.1 months,11.3 months and 8.1 months(P=0.032),respectively.The mOS of three groups was 21.9 months,26.2 months and 17.1 months,respectively(P=0.085).Conclusions:Our research indicated that delayed brain RT may result in inferior iPFS in EGFR mutated NSCLC patients with asymptomatic brain metastases,but no OS benefit was obtained.In addition,our study revealed that patients treated with SRS had a significantly longer OS for symptomatic BM.Future prospective study of optimal management strategy with WBRT or SRS and TKI for this patient cohort is urgently needed.
Brain metastases EGFR TKI non-small cell lung cancer radiotherapy
Wenxian Wang Zhengbo Song Yiping Zhang
Department of Chemotherapy,Zhejiang Cancer Hospital,Hangzhou,China Department of Chemotherapy,Zhejiang Cancer Hospital,Hangzhou,China;Key Laboratory Diagnosis and Trea
国内会议
合肥
英文
1-16
2017-06-15（万方平台首次上网日期，不代表论文的发表时间）