Combination of Whole-Brain Radiotherapy with Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors Improves Overall Survival in EGFR-Mutated Non-Small Cell Lung Cancer Patients with Brain Metastases

被引：21

作者：

Chen, Chien-Hung ^{[1
,2
]}

Lee, Hsin-Hua ^{[3
,4
,5
]}

Chuang, Hung-Yi ^{[2
,6
]}

Hung, Jen-Yu ^{[7
,8
]}

Huang, Ming-Yii ^{[2
,3
,4
,5
,9
,10
,11
,12
]}

Chong, Inn-Wen ^{[2
,7
,8
,13
]}

机构：

[1] Kaohsiung Municipal Tatung Hosp, Dept Radiat Oncol, Kaohsiung 80145, Taiwan

[2] Kaohsiung Med Univ, Coll Med, Grad Inst Med, Kaohsiung 80708, Taiwan

[3] Kaohsiung Med Univ, PhD Program Environm & Occupat Med, Kaohsiung 80708, Taiwan

[4] Natl Hlth Res Inst, Kaohsiung 80708, Taiwan

[5] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Radiat Oncol, Kaohsiung 80708, Taiwan

[6] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Occupat & Environm Med, Kaohsiung 80708, Taiwan

[7] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Internal Med, Div Pulm & Crit Care Med, Kaohsiung 80708, Taiwan

[8] Kaohsiung Med Univ, Coll Med, Sch Med, Kaohsiung 80708, Taiwan

[9] Kaohsiung Med Univ, Coll Med, Fac Med, Dept Radiat Oncol, Kaohsiung 80708, Taiwan

[10] Kaohsiung Med Univ, Ctr Drug Dev, Kaohsiung 80708, Taiwan

[11] Kaohsiung Med Univ, Value Creat Res Ctr, Kaohsiung 80708, Taiwan

[12] Kaohsiung Med Univ, Ctr Canc Res, Kaohsiung 80708, Taiwan

[13] Kaohsiung Med Univ, Coll Med, Fac Med, Dept Resp Therapy, Kaohsiung 80708, Taiwan

来源：

CANCERS | 2019年 / 11卷 / 08期

关键词：

brain metastases; epidermal growth factor receptor; non-small cell lung cancer; whole-brain radiotherapy; tyrosine kinase inhibitors; SURGICAL RESECTION; RADIATION-THERAPY; BARRIER PERMEABILITY; RADIOSURGERY; ADENOCARCINOMA; MANAGEMENT; MUTATIONS; DIAGNOSIS; EFFICACY; TUMORS;

D O I：

10.3390/cancers11081092

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Brain metastases (BM) cause morbidity and mortality in patients with non-small cell lung cancer (NSCLC). The use of upfront epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) and withholding of whole-brain radiation therapy (WBRT) is controversial. We aim to investigate the impact of WBRT on overall survival (OS). After screening 1384 patients, a total of 141 EGFR-mutated patients with NSCLC and BM were enrolled. All patients received EGFR-TKIs between 2011 and 2015. Ninety-four patients (66.7%) were treated with WBRT (TKI + WBRT group). With a median follow-up of 20.3 months (95% confidence interval (CI), 16.9-23.7), the median OS after the diagnosis of BM was 14.3 months (95% CI, 9.5 to 18.3) in the TKI + WBRT group and 2.3 months (95% CI, 2 to 2.6) in the TKI alone group. On multivariate analysis, WBRT (p < 0.001), female, surgery to primary lung tumor, and surgery to BM were associated with improved OS. The 1-year OS rate was longer in the TKI+WBRT group than that in the TKI alone group (81.9% vs. 59.6%, p = 0.002). In conclusion, this is the first study to demonstrate the negative survival impact from the omission of WBRT in patients with EGFR-mutant NSCLC.

引用

页数：14

共 48 条

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