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Article: Concurrent brain radiotherapy and EGFR-TKI may improve intracranial metastases control in non-small cell lung cancer and have survival benefit in patients with low DS-GPA score

TitleConcurrent brain radiotherapy and EGFR-TKI may improve intracranial metastases control in non-small cell lung cancer and have survival benefit in patients with low DS-GPA score
Authors
KeywordsEGFR-TKI
Non-small cell lung cancer
EGFR mutation
Brain radiotherapy
Brain metastasis
Issue Date2017
Citation
Oncotarget, 2017, v. 8, n. 67, p. 111309-111317 How to Cite?
Abstract© Liu et al. Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) has intracranial activity in EGFR-mutant Non-Small Cell Lung Cancer (NSCLC). The optimal timing of brain radiotherapy (RT) and appropriate patients who need early brain RT remains undetermined. This is a retrospective study of EGFR-mutant NSCLC patients with newly diagnosed brain metastases (BMs) before EGFR-TKI initiation. Intracranial progression free survival (IC-PFS) and overall survival (OS) were measured from the date of EGFR-TKI treatment. A total of 113 patients were eligible, 49 received concurrent early brain RT with EGFR-TKI and 64 were treated with EGFR-TKI alone as initial therapy, including 27 with salvage RT upon BM progression. The patients with early brain RT had superior IC-PFS than those without early brain RT (21.4 vs 15.0 months, P=0.001), which remained significant in multivariate analysis (HR 0.30, P < 0.001). The median overall survival (OS) for early RT, EGFR-TKI alone and salvage RT groups was 28.1, 24.5, and 24.6 months, respectively (P=0.604). Similar IC-PFS (23.6 vs 21.4 months, P=0.253) and OS (24.6 vs 28.1 months, P=0.385) were observed between salvage RT and early RT groups. For patients with Diagnosis- Specific Graded Prognostic Assessment (DS-GPA) score of 0 to 2, early brain RT was the independent factor for improved OS (HR 0.33, P=0.025). In conclusion, concurrent early brain RT with EGFR-TKI may improve intracranial disease control in EGFRmutant NSCLC with BM and have survival benefit in patients with low DS-GPA score. Salvage brain RT upon BM progression may be acceptable in some patients.
Persistent Identifierhttp://hdl.handle.net/10722/266813
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLiu, Yongmei-
dc.contributor.authorDeng, Lei-
dc.contributor.authorZhou, Xiaojuan-
dc.contributor.authorGong, Youling-
dc.contributor.authorXu, Yong-
dc.contributor.authorZhou, Lin-
dc.contributor.authorWan, Jin-
dc.contributor.authorZou, Bingwen-
dc.contributor.authorWang, Yongsheng-
dc.contributor.authorZhu, Jiang-
dc.contributor.authorDing, Zhenyu-
dc.contributor.authorPeng, Feng-
dc.contributor.authorHuang, Meijuan-
dc.contributor.authorRen, Li-
dc.contributor.authorLautenschlaeger, Tim-
dc.contributor.authorKong, Feng Ming-
dc.contributor.authorLu, You-
dc.date.accessioned2019-01-31T07:19:41Z-
dc.date.available2019-01-31T07:19:41Z-
dc.date.issued2017-
dc.identifier.citationOncotarget, 2017, v. 8, n. 67, p. 111309-111317-
dc.identifier.urihttp://hdl.handle.net/10722/266813-
dc.description.abstract© Liu et al. Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) has intracranial activity in EGFR-mutant Non-Small Cell Lung Cancer (NSCLC). The optimal timing of brain radiotherapy (RT) and appropriate patients who need early brain RT remains undetermined. This is a retrospective study of EGFR-mutant NSCLC patients with newly diagnosed brain metastases (BMs) before EGFR-TKI initiation. Intracranial progression free survival (IC-PFS) and overall survival (OS) were measured from the date of EGFR-TKI treatment. A total of 113 patients were eligible, 49 received concurrent early brain RT with EGFR-TKI and 64 were treated with EGFR-TKI alone as initial therapy, including 27 with salvage RT upon BM progression. The patients with early brain RT had superior IC-PFS than those without early brain RT (21.4 vs 15.0 months, P=0.001), which remained significant in multivariate analysis (HR 0.30, P < 0.001). The median overall survival (OS) for early RT, EGFR-TKI alone and salvage RT groups was 28.1, 24.5, and 24.6 months, respectively (P=0.604). Similar IC-PFS (23.6 vs 21.4 months, P=0.253) and OS (24.6 vs 28.1 months, P=0.385) were observed between salvage RT and early RT groups. For patients with Diagnosis- Specific Graded Prognostic Assessment (DS-GPA) score of 0 to 2, early brain RT was the independent factor for improved OS (HR 0.33, P=0.025). In conclusion, concurrent early brain RT with EGFR-TKI may improve intracranial disease control in EGFRmutant NSCLC with BM and have survival benefit in patients with low DS-GPA score. Salvage brain RT upon BM progression may be acceptable in some patients.-
dc.languageeng-
dc.relation.ispartofOncotarget-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectEGFR-TKI-
dc.subjectNon-small cell lung cancer-
dc.subjectEGFR mutation-
dc.subjectBrain radiotherapy-
dc.subjectBrain metastasis-
dc.titleConcurrent brain radiotherapy and EGFR-TKI may improve intracranial metastases control in non-small cell lung cancer and have survival benefit in patients with low DS-GPA score-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.18632/oncotarget.22785-
dc.identifier.scopuseid_2-s2.0-85038443208-
dc.identifier.volume8-
dc.identifier.issue67-
dc.identifier.spage111309-
dc.identifier.epage111317-
dc.identifier.eissn1949-2553-
dc.identifier.isiWOS:000419567000048-

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