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The necessity of EGFR-targeted therapy combined with synchronized whole brain radiotherapy for non-small-cell lung cancer with mutated EGFR and brain metastasis
Su Pengcheng,Cao Jianzhong,Li Hongwei
Cancer Hospital,Shanxi Medical University,Taiyuan 030013,China (Su PC);Department of Radiation Oncology,Shanxi Cancer Hospital,Taiyuan 030013,China (Cao JZH,Li HW)
AbstractObjective To explore the necessity of EGFR-targeted therapy combined with synchronized whole brain radiotherapy (WBRT) for non-small-cell lung cancer (NSCLC) with mutated EGFR and brain metastasis by comparing the effects on prognosis between WBRT combined with tyrosine kinase inhibitor (TKI) and TKI alone. Methods A retrospective analysis was performed in 43 patients with EGFR mutation-positive NSCLC and brain metastasis. In those patients, 24 patients received WBRT plus TKI and 19 patients TKI alone. Results The overall response rate (RR) and 6-month intracranial disease control rate (CR) were significantly higher in the WBRT+TKI group than in the TKI group (79% vs. 37%, P=0.002;79% vs. 63%, P=0.008). The median intracranial progression-free survival (IPFS) time was significantly longer in the WBRT+TKI group than in the TKI group (23.7 vs. 8.3 months, P=0.025). The multivariate analysis indicated that the control of lung cancer, WBRT+TKI, and single brain metastasis were favorable factors for substantially longer IPFS time (P=0.033,0.019,0.019). In 23 patients with exon 19 deletion, 12 patients received WBRT+TKI and 11 patients TKI alone;compared with the TKI group, the WBRT+TKI group had significantly higher RR and 6-month CR as well as significantly longer IPFS (100% vs. 35%, P=0.000;100% vs. 55%, P=0.008;23.7 vs. 8.4 months, P=0.003). In 20 patients without exon 19 deletion, however, there were no significant differences in RR or 6-month CR between the WBRT+TKI group (n=12) and the TKI group (n=8)(64% vs. 50%, P=1.000;58% vs. 75%, P=0.642).The median IPFS was 14.4 and 8.4 months (P=0.864). Conclusions WBRT combined with TKI is superior to TKI alone in the treatment of NSCLC with brain metastasis. Patients with exon 19 deletion have substantially better treatment outcomes.
Corresponding Authors:
Li Hongwei,Email:3420010@163.com
E-mail: 3420010@163.com
Cite this article:
Su Pengcheng,Cao Jianzhong,Li Hongwei. The necessity of EGFR-targeted therapy combined with synchronized whole brain radiotherapy for non-small-cell lung cancer with mutated EGFR and brain metastasis[J]. Chinese Journal of Radiation Oncology, 2016, 25(8): 823-828.
Su Pengcheng,Cao Jianzhong,Li Hongwei. The necessity of EGFR-targeted therapy combined with synchronized whole brain radiotherapy for non-small-cell lung cancer with mutated EGFR and brain metastasis[J]. Chinese Journal of Radiation Oncology, 2016, 25(8): 823-828.
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2016, Vol. 25 
