Department of Radiation and Medical Oncology, the First Affiliated Hospital of Wenzhou Medical University, No.2 Fuxue Lane, Wenzhou, 325000, Zhejiang, China.
Department of Ultrasonography, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang, China.
Radiat Oncol. 2019 Dec 31;15(1):3. doi: 10.1186/s13014-019-1454-2.
BACKGROUND: The development of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has dramatically improved the prognosis of patients with EGFR-mutant non-small-cell lung cancer (NSCLC). The purpose of this study is to investigate the clinical outcome with or without EGFR-TKI resistance before WBRT and the sequence between EGFT-TKIs and whole brain radiotherapy (WBRT) of EGFR-mutant NSCLC patients who developed multiple brain metastases (BMs). PATIENTS AND METHODS: Three hundred forty-four EGFR-mutant NSCLC patients with multiple BMs were reviewed. Enrolled patients were divided into TKI-naïve group and TKI-resistant group. The intracranial progression-free survival (PFS) and overall survival (OS) were analyzed via the Kaplan-Meier method. RESULTS: For patients with multiple BMs treated by WBRT, the median intracranial PFS and OS were longer in the TKI-naïve group than those in the TKI-resistant group, but there were no statistically significant between two groups (Intracranial PFS: 7.7 vs. 5.4 months, p = 0.052; OS: 11.2 vs. 9.2 months, p = 0.106). For patients with Lung-molGPA 0-2, no significant differences in median intracranial PFS (6.2 vs. 5.2 months, p = 0.123) and OS (7.8 vs. 6.7 months, p = 0.514) between TKI-naïve and TKI-resistant groups. For patients with Lung-molGPA 2.5-4, intracranial PFS: 12.8 vs. 10.1 months; OS: 23.3 vs. 15.3 months. CONCLUSIONS: Our study found that there were no difference in intracranial PFS and OS in all patients between the two groups of TKI-naïve and TKI-resistant. But for patients in subgroup of Lung-molGPA 2.5-4, there were a better intracranial PFS and OS in TKI-naïve group.
背景：表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）的发展显著改善了 EGFR 突变型非小细胞肺癌（NSCLC）患者的预后。本研究旨在探讨 EGFR 突变型 NSCLC 患者发生多发性脑转移（BMs）时，在接受全脑放疗（WBRT）之前 EGFR-TKI 耐药的临床结果，以及 EGFT-TKIs 与全脑放疗（WBRT）之间的顺序。 方法：回顾性分析了 344 例 EGFR 突变型 NSCLC 伴多发脑转移患者的临床资料。将入组患者分为 TKI 初治组和 TKI 耐药组。采用 Kaplan-Meier 法分析颅内无进展生存期（PFS）和总生存期（OS）。 结果：对于接受 WBRT 治疗的多发脑转移患者，TKI 初治组的颅内 PFS 和 OS 均长于 TKI 耐药组，但两组间无统计学差异（颅内 PFS：7.7 个月 vs. 5.4 个月，p=0.052；OS：11.2 个月 vs. 9.2 个月，p=0.106）。对于 Lung-molGPA 0-2 的患者，TKI 初治组和 TKI 耐药组的颅内 PFS （6.2 个月 vs. 5.2 个月，p=0.123）和 OS （7.8 个月 vs. 6.7 个月，p=0.514）差异无统计学意义。对于 Lung-molGPA 2.5-4 的患者，颅内 PFS：12.8 个月 vs. 10.1 个月；OS：23.3 个月 vs. 15.3 个月。 结论：本研究发现，TKI 初治组和 TKI 耐药组患者的颅内 PFS 和 OS 差异无统计学意义。但对于 Lung-molGPA 2.5-4 亚组患者，TKI 初治组的颅内 PFS 和 OS 更好。
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