Osaka Shunzo, Kawashima Junzo, Kaguchi Ryoma, Toda Naoki, Kisohara Akira, Kan Shumei, Tagawa Kohei, Kojima Toshio, Nagai Takako, Osaka Eiji, Nakanishi Kazuyoshi, Tanaka Yoshiaki
Orthopaedic Surgery,Kasukabe Medical Center, Saitama, Japan.
Respiratory Medicine,Kasukabe Medical Center, Saitama, Japan.
Cancer Diagn Progn. 2025 May 3;5(3):386-395. doi: 10.21873/cdp.10451. eCollection 2025 May-Jun.
BACKGROUND/AIM: This study analyzed prognostic factors in patients with lung adenocarcinoma and bone metastases who tested positive for epidermal growth factor receptor (EGFR) mutations.
We retrospectively reviewed the records of 117 patients with lung adenocarcinoma and bone metastases who were followed up at a single institution for 0.2 months to 66 months. Of these 117 patients, 45 were EGFR mutation-positive and further analysis was performed for these patients. Median survival times and five-year survival rates were investigated according to performance status (PS), oligometastatic status, radiotherapy and EGFR-tyrosine kinase inhibitor (TKI) administration.
The five-year survival rate of EGFR mutation-positive patients was 9.2%, and median survival time was 22.7 months; their mean age was 69.5 years. Many EGFR mutation-positive patients had a PS of 2, and the median survival time showed significant differences according to PS (0/1/2 vs. 3/4) and oligometastatic status.
Although there was no difference in the mean survival time between patients receiving or not receiving bone radiotherapy, the treatment effectively reduced pain and prevented paralysis. As a first-line treatment in EGFR mutation-positive patients, first- or second-generation TKIs followed by third-generation TKIs showed favorable outcomes.
背景/目的：本研究分析了表皮生长因子受体（EGFR）突变检测呈阳性的肺腺癌伴骨转移患者的预后因素。
我们回顾性分析了117例肺腺癌伴骨转移患者的病历，这些患者在单一机构接受了0.2个月至66个月的随访。在这117例患者中，45例EGFR突变呈阳性，并对这些患者进行了进一步分析。根据体能状态（PS）、寡转移状态、放疗及EGFR酪氨酸激酶抑制剂（TKI）给药情况，研究了中位生存时间和五年生存率。
EGFR突变阳性患者的五年生存率为9.2%，中位生存时间为22.7个月；他们的平均年龄为69.5岁。许多EGFR突变阳性患者的PS为2，中位生存时间根据PS（0/1/2与3/4）及寡转移状态显示出显著差异。
虽然接受或未接受骨放疗的患者平均生存时间无差异，但该治疗有效减轻了疼痛并预防了瘫痪。作为EGFR突变阳性患者的一线治疗，第一代或第二代TKI随后使用第三代TKI显示出良好的疗效。
