突变对接受立体定向放射外科治疗的非小细胞肺癌患者脑转移控制的影响。
Impact of mutations on brain metastasis control in non-small cell lung cancer patients undergoing stereotactic radiosurgery.
作者信息
Leng Jim X, Su Chang, Carpenter David J, Floyd Warren, Vaios Eugene, Shenker Rachel, Hendrickson Peter G, Giles Will, Mullikin Trey, Floyd Scott R, Kirkpatrick John P, Green Michelle, Reitman Zachary J
机构信息
Department of Radiation Oncology, Duke University Medical Center, Durham, NC, 27710, USA.
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
出版信息
J Radiosurg SBRT. 2024;9(2):91-99.
PURPOSE
To investigate whether TP53 variants may be correlated with overall survival and local control following stereotactic radiosurgery (SRS) for brain metastases (BMs) from non-small cell lung cancer (NSCLC).
METHODS
Patients undergoing an initial course of SRS for NSCLC brain metastases between 1/2015 and 12/2020 were retrospectively identified. Overall survival and freedom from local intracranial progression (FFLIP) were estimated via Kaplan-Meier method. Cox models assessed TP53 variant status (pathogenic variant, PV; variant not detected, ND).
RESULTS
255 patients underwent molecular profiling for TP53, among whom 144 (56%) had a TP53 PV. Median follow-up was 11.6 months. OS was not significantly different across TP53 status. A trend toward superior FFLIP was observed for PV (95% CI 62.9 months-NR) versus ND patients (95% CI 29.4 months-NR; p=0.06). Superior FFLIP was observed for patients with one TP53 variant versus those with TP53 ND.
CONCLUSION
Among NSCLC patients with BMs, the potential association between TP53 status and post-SRS FFLIP warrants further investigation in a larger prospective cohort.
目的
研究TP53基因变异是否与非小细胞肺癌（NSCLC）脑转移瘤（BMs）立体定向放射外科治疗（SRS）后的总生存期和局部控制情况相关。
方法
回顾性纳入2015年1月至2020年12月期间接受NSCLC脑转移瘤首次SRS治疗的患者。采用Kaplan-Meier法估计总生存期和无局部颅内进展生存期（FFLIP）。Cox模型评估TP53基因变异状态（致病变异，PV；未检测到变异，ND）。
结果
255例患者接受了TP53基因分子检测，其中144例（56%）存在TP53 PV。中位随访时间为11.6个月。不同TP53状态的患者总生存期无显著差异。观察到PV组（95%CI 62.9个月-未达到）的FFLIP有优于ND组（95%CI 29.4个月-未达到；p=0.06）的趋势。单TP53变异患者的FFLIP优于TP53 ND患者。
结论
在NSCLC脑转移瘤患者中，TP53状态与SRS后FFLIP之间的潜在关联值得在更大的前瞻性队列中进一步研究。
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