IV期非小细胞肺癌的放疗与酪氨酸激酶抑制剂：真实世界经验
Radiotherapy and Tyrosine Kinase Inhibitors in Stage IV Non-small Cell Lung Cancer: Real-life Experience.
作者信息
Borghetti Paolo, Bonù Marco Lorenzo, Roca Elisa, Pedretti Sara, Salah Emiliano, Baiguini Anna, Greco Diana, Triggiani Luca, Maddalo Marta, Levra Niccolò Giaj, Alongi Filippo, Magrini Stefano Maria, Buglione Michela
机构信息
Department of Radiation Oncology, Olindo Alberti Radiotherapy Institute, Brescia, Italy
Department of Radiation Oncology, Brescia University, Brescia, Italy.
出版信息
In Vivo. 2018 Jan-Feb;32(1):159-164. doi: 10.21873/invivo.11219.
AIM
To investigate the role of conventional radiotherapy (RT) and stereotactic body radiotherapy (SBRT) in patients with epidermal growth factor (EGFR)-mutant or anaplastic lymphoma kinase (ALK) rearrangement-positive metastatic non-small cell lung cancer (NSCLC).
PATIENTS AND METHODS
Fifty patients with EGFR-mutated or ALK rearrangement-positive NSCLC were treated at our Institution. Radiotherapy was delivered before, after or concomitantly with tyrosine kinase inhibitors (TKIs). Acute toxicities and overall survival (OS) were assessed.
RESULTS
Radiotherapy was performed within 30 days before TKI, concomitantly with TKI and within 30 days after TKI in eight (16%), 33 (66%) and 9 (18%) cases, respectively. The median duration of TKI therapy in the whole series was 11.9 months. The median OS was 19.3 months and 1- and 2-year OS was 71.5% and 36.5%, respectively. The group treated with SBRT had a significant benefit in terms of OS (p=0.043). Only two grade 3 toxicities were reported.
CONCLUSION
RT concomitantly or close to TKI administration in stage IV NSCLC was shown to be feasible and safe. Intriguing data on OS were also reported.
目的
探讨传统放疗（RT）和立体定向体部放疗（SBRT）在表皮生长因子（EGFR）突变或间变性淋巴瘤激酶（ALK）重排阳性的转移性非小细胞肺癌（NSCLC）患者中的作用。
患者与方法
50例EGFR突变或ALK重排阳性的NSCLC患者在我院接受治疗。放疗在酪氨酸激酶抑制剂（TKIs）之前、之后或同时进行。评估急性毒性和总生存期（OS）。
结果
放疗分别在TKI前30天内、与TKI同时以及TKI后30天内进行，分别为8例（16%）、33例（66%）和9例（18%）。整个系列中TKI治疗的中位持续时间为11.9个月。中位OS为19.3个月，1年和2年OS分别为71.5%和36.5%。接受SBRT治疗的组在OS方面有显著益处（p = 0.043）。仅报告了2例3级毒性反应。
结论
在IV期NSCLC中，放疗与TKI同时或接近TKI给药被证明是可行且安全的。还报告了关于OS的有趣数据。
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