State Key Laboratory of Oncology in South China, Guangzhou, China; Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Guangzhou, China; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.
Clin Lung Cancer. 2017 Nov;18(6):e369-e373. doi: 10.1016/j.cllc.2017.04.002. Epub 2017 Apr 12.
The effect of local therapy (LT) for oligoprogressive epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC) has not been well established. Forty-six patients with stage IIIB/IV EGFR-mutated NSCLC were treated by LT and continuing tyrosine kinase inhibitors (TKIs) for oligoprogression. The median overall survival (OS) and progression-free survival (PFS) after LT were 13.0 and 7.0 months, respectively. EGFR mutation type, sites of LT, and time from first progressive disease (PD) to LT were prognostic of OS after LT.
Patients with advanced stage EGFR-mutated NSCLC treated with EGFR TKIs could experience oligoprogression. This study investigated the benefits of LT and continuation of TKIs for oligoprogression retrospectively.
Forty-six patients with stage IIIB/IV EGFR-mutated NSCLC on TKIs were treated by LT and continuation of TKIs for oligoprogressive disease. The impact of clinicopathologic variables on survival was explored using Cox regression.
With a median follow-up of 32 months, the 2-year OS was 65.2%, and the estimated OS was 35.0 months. The median OS after LT (LT-OS) was 13.0 months. The median PFS after LT (LT-PFS) was 7.0 months. Univariate analysis showed that stage at initial diagnosis, EGFR mutation type, site of LT, metastatic status at initial TKIs, and time from first PD to LT correlated with LT-OS significantly. Multivariate analysis suggested that EGFR mutation type (P = .001), sites of LT (P = .000), and time from first PD to LT (P = .034) were prognostic of LT-OS. Univariate analysis showed that metastatic status at initial TKIs and time from first PD to LT correlated with LT-PFS significantly. Multivariate analysis suggested that only time from first PD to LT (P = .000) was prognostic of LT-PFS.
This study revealed that LTs are feasible and effective for EGFR-mutated NSCLC with oligoprogression. EGFR mutation type, sites of LT, and time from first PD to LT were prognostic factors for LT-OS. Time from first PD to LT was a prognostic factor for LT-PFS.
局部治疗（LT）对寡进展性表皮生长因子受体（EGFR）突变的非小细胞肺癌（NSCLC）的疗效尚未得到充分证实。46 例 IIIB/IV 期 EGFR 突变 NSCLC 患者接受 LT 联合持续酪氨酸激酶抑制剂（TKI）治疗寡进展。LT 后中位总生存期（OS）和无进展生存期（PFS）分别为 13.0 个月和 7.0 个月。LT 后 OS 的预后因素包括 EGFR 突变类型、LT 部位和从首次进展性疾病（PD）到 LT 的时间。
接受 EGFR TKI 治疗的晚期 EGFR 突变 NSCLC 患者可能会出现寡进展。本研究回顾性探讨 LT 联合 TKI 治疗寡进展的疗效。
46 例 IIIB/IV 期 EGFR 突变 NSCLC 患者在接受 TKI 治疗的基础上接受 LT 联合 TKI 治疗寡进展性疾病。采用 COX 回归分析探讨临床病理变量对生存的影响。
中位随访 32 个月时，2 年 OS 率为 65.2%，估计 OS 为 35.0 个月。LT 后中位 OS（LT-OS）为 13.0 个月。LT 后中位 PFS（LT-PFS）为 7.0 个月。单因素分析显示，初诊时的分期、EGFR 突变类型、LT 部位、初诊 TKI 时的转移状态和从首次 PD 到 LT 的时间与 LT-OS 显著相关。多因素分析提示，EGFR 突变类型（P=0.001）、LT 部位（P=0.000）和从首次 PD 到 LT 的时间（P=0.034）是 LT-OS 的预后因素。单因素分析显示，初诊 TKI 时的转移状态和从首次 PD 到 LT 的时间与 LT-PFS 显著相关。多因素分析提示，只有从首次 PD 到 LT 的时间（P=0.000）是 LT-PFS 的预后因素。
本研究表明，LT 对 EGFR 突变 NSCLC 的寡进展是可行和有效的。EGFR 突变类型、LT 部位和从首次 PD 到 LT 的时间是 LT-OS 的预后因素。从首次 PD 到 LT 的时间是 LT-PFS 的预后因素。
