論文

国際誌
2019年11月

Efficacy of EGFR-TKIs with or without upfront brain radiotherapy for EGFR-mutant NSCLC patients with central nervous system metastases.

Thoracic cancer
  • Yu Saida
  • ,
  • Satoshi Watanabe
  • ,
  • Tetsuya Abe
  • ,
  • Satoshi Shoji
  • ,
  • Koichiro Nozaki
  • ,
  • Kosuke Ichikawa
  • ,
  • Rie Kondo
  • ,
  • Kenichi Koyama
  • ,
  • Satoru Miura
  • ,
  • Hiroshi Tanaka
  • ,
  • Masaaki Okajima
  • ,
  • Masaki Terada
  • ,
  • Takashi Ishida
  • ,
  • Hiroki Tsukada
  • ,
  • Masato Makino
  • ,
  • Akira Iwashima
  • ,
  • Kazuhiro Sato
  • ,
  • Naoya Matsumoto
  • ,
  • Hirohisa Yoshizawa
  • ,
  • Toshiaki Kikuchi

10
11
開始ページ
2106
終了ページ
2116
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/1759-7714.13189

BACKGROUND: Although the clinical efficacy of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in EGFR-mutant non-small cell lung cancer (NSCLC) patients has been demonstrated, their efficacy in EGFR-mutant NSCLCs with central nervous system (CNS) metastases and the role of radiotherapy remain unclear. This study aimed to determine if it is preferable to add upfront cranial radiotherapy to EGFR-TKIs in patients with EGFR-mutant NSCLC with newly diagnosed brain metastases. METHODS: We retrospectively analyzed the data of EGFR-mutant NSCLC patients with CNS metastases who received EGFR-TKIs as a first-line therapy. RESULTS: A total of 104 patients were enrolled and 39 patients received upfront brain radiotherapy, while 65 patients received first and second generation EGFR-TKIs first. The median time to treatment failure (TTF) was 7.8 months (95% confidence interval [CI]: 6.3-9.4). The median survival time (MST) was 24.0 months (95% CI: 20.1-30.1). The overall response rate of the CNS was 37%. The median CNS progression-free survival (PFS) was 13.2 months (95% CI: 10.0-16.2). Brain radiotherapy prior to EGFR-TKI prolonged TTF (11.2 vs. 6.8 months, P = 0.038) and tended to prolong CNS-PFS (15.6 vs. 11.1 months, P = 0.096) but was not significantly associated with overall survival (MST 26.1 vs. 24.0 months, P = 0.525). Univariate and multivariate analyses indicated that poor performance status and the presence of extracranial metastases were poor prognostic factors related to overall survival. CONCLUSION: EGFR-TKI showed a favorable effect for EGFR-mutant NSCLC patients with CNS metastases. Prolonged TTF and CNS-PFS were observed with upfront brain radiotherapy.

リンク情報
DOI
https://doi.org/10.1111/1759-7714.13189
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31507098
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6825912
ID情報
  • DOI : 10.1111/1759-7714.13189
  • PubMed ID : 31507098
  • PubMed Central 記事ID : PMC6825912

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