EGFR mutant status and tyrosine-kinase inhibitors affect the GKRS outcomes for NSCLC brain metastases

被引:1
|
作者
Liao, Hung-Ruei [1 ]
Chiang, Chi-Lu [3 ,5 ,8 ]
Shen, Chia-, I [3 ,5 ,8 ]
Chen, Ching-Jen [9 ]
Yang, Huai-Che [1 ,3 ]
Wu, Hsiu-Mei [2 ,3 ]
Luo, Yung-Hung [3 ,5 ,8 ]
Hu, Yong-Sin [2 ,3 ]
Lin, Chung-Jung [2 ,3 ]
Chung, Wen-Yuh [1 ,3 ,10 ]
Shiau, Cheng-Ying [3 ,4 ]
Guo, Wan-Yuo [2 ,3 ]
Pan, David Hung-Chi [1 ,7 ]
Lee, Cheng-Chia [1 ,3 ,6 ]
机构
[1] Taipei Vet Gen Hosp, Neurol Inst, Dept Neurosurg, Taipei, Taiwan
[2] Taipei Vet Gen Hosp, Dept Radiol, Taipei, Taiwan
[3] Natl Yang Ming Univ, Sch Med, Taipei, Taiwan
[4] Taipei Vet Gen Hosp, Canc Ctr, Taipei, Taiwan
[5] Taipei Vet Gen Hosp, Dept Chest Med, Taipei, Taiwan
[6] Natl Yang Ming Univ, Brain Res Ctr, Taipei, Taiwan
[7] Taipei Med Univ, Shuang Ho Hosp, Dept Neurosurg, Taipei, Taiwan
[8] Natl Yang Ming Univ, Sch Med, Inst Clin Med, Taipei, Taiwan
[9] Univ Texas Hlth Sci Ctr Houston, Dept Neurosurg, Houston, TX 77030 USA
[10] Kaohsiung Vet Gen Hosp, Gamma Knife Ctr, Kaohsiung, Taiwan
关键词
Gamma knife; EGFR; Mutations; Survival; Tumor control; Radiosurgery; Brain metastasis; Tyrosine-kinase inhibitor; Wild type; Non-small cell lung cancer; Stereotactic surgery; CELL LUNG-CANCER; WILD-TYPE EGFR; 2ND-LINE TREATMENT; RADIATION NECROSIS; MUTATION STATUS; GROWTH; EFFICACY; THERAPY; CHEMOTHERAPY; RADIOTHERAPY;
D O I
10.1007/s11060-022-04110-8
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective Tyrosine kinase inhibitors (TKIs) is the first-line treatment for EGFR-positive non-small cell lung cancer (NSCLC); however, its applicability to patients with wild-type NSCLC remains an issue of contention. This study compared the effects of gamma knife radiosurgery (GKRS) alone versus combining GKRS and TKIs in treating two genetic forms of NSCLC. Methods This retrospective study examined 479 NSCLC patients with 1982 brain metastases who underwent GKRS and for whom imaging follow-up data or death records were available. All our patients were consecutive. All gene mutations were confirmed by lung biopsy. The three main endpoints in this study were overall survival (OS), local intracranial tumor control (LC), and distal intracranial tumor control (DC). Results There were 296 NSCLC patients with EGFR positive: TKI treatment (n = 262) and without TKI treatment (n = 34). GKRS + TKIs was more effective than GKRS alone in terms of OS (HR 0.53, p = 0.085) and DC (HR 0.51, p < 0.001). There were 150 NSCLC patients with wild-type EGFR: TKI treatment (n = 50) and without TKI treatment (n = 100). GKRS + TKIs was less effective than GKRS alone in terms of OS (HR 1.82, p = 0.049) and DC (HR: 1.40, p = 0.011). We observed no difference in terms of LC in both genetic groups. Conclusions Combining GKRS with TKIs proved effective in EGFR positive NSCLC patients; however, we do not observe the similar results when combining GKRS with TKIs for patients with wild-type NSCLC.
引用
收藏
页码:675 / 684
页数:10
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