Wenzhou Medical University, Wenzhou, China.
Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China.
Sci Rep. 2017 Mar 23;7:45193. doi: 10.1038/srep45193.
EGFR-TKIs and radiation therapy (RT) are the principal treatment for patients with brain metastases (BM) and EGFR mutant NSCLC. However, the optimal use of brain RT for patients with asymptomatic BM remains undefined. A total of 152 patients were identified. 58 patients were excluded. Of the remaining 97 patients, 56 patients received upfront RT followed by icotinib, including WBRT or SRS. 41 patients received icotinib therapy alone. The mOS from diagnosis of BM was 27.0 months for the whole cohort (95% CI, 23.9-30.1 months). There was no difference in OS between the RT followed by icotinib group and the icotinib alone group (31.9 vs. 27.9 months, P = 0.237), and similar results were found in the SRS subgroup (35.5 vs. 27.9 months, P = 0.12). Patients with the EGFR Del19 mutation had a longer OS than patients with the exon 21 L858R mutation (32.7 vs. 27.4, P = 0.037). Intracranial progression-free survival (PFS) was improved in the patients who received RT followed by icotinib compared to those receiving icotinib alone (22.4 vs. 13.9 months, P = 0.043). Patients with EGFR-mutant adenocarcinoma and BM treated with icotinib exhibited prolonged survival. A longer duration of intracranial control was observed with brain RT.
表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）和放射治疗（RT）是治疗脑转移（BM）和 EGFR 突变非小细胞肺癌（NSCLC）患者的主要方法。然而，对于无症状 BM 患者，脑 RT 的最佳应用仍未确定。共确定了 152 名患者，其中 58 名患者被排除在外。在剩余的 97 名患者中，56 名患者接受了脑 RT 联合厄洛替尼治疗，包括全脑放疗或立体定向放射治疗。41 名患者单独接受厄洛替尼治疗。从 BM 诊断开始，整个队列的 mOS 为 27.0 个月（95%CI，23.9-30.1 个月）。接受 RT 联合厄洛替尼治疗组与单独接受厄洛替尼治疗组的 OS 无差异（31.9 与 27.9 个月，P=0.237），在 SRS 亚组中也得到了类似的结果（35.5 与 27.9 个月，P=0.12）。携带 EGFR Del19 突变的患者 OS 长于携带 exon 21 L858R 突变的患者（32.7 与 27.4 个月，P=0.037）。与单独接受厄洛替尼治疗的患者相比，接受 RT 联合厄洛替尼治疗的患者颅内无进展生存期（PFS）得到改善（22.4 与 13.9 个月，P=0.043）。接受厄洛替尼治疗的 EGFR 突变型腺癌和 BM 患者的生存时间延长。脑 RT 可延长颅内控制时间。
Zotero 插件
