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Objectives <p>Patients with epidermal growth factor receptor (<i>EGFR</i>)-mutant non-small cell lung cancer (NSCLC) are at a heightened risk of developing brain metastases (BM). <i>EGFR</i>-tyrosine kinase inhibitors (TKI) are standard treatment for <i>EGFR</i>-mutated NSCLC. However, the necessity and optimal approach of brain radiotherapy for NSCLC patients with <i>EGFR</i> mutation remain inconclusive. We aimed to answer these questions by retrospectively analyzing the efficacy of radiotherapy in patients with BM from NSCLC with <i>EGFR</i> mutations.</p> Methods <p>Patients with <i>EGFR</i>- mutant NSCLC and BMs who were diagnosed between January 1, 2018 and December 31, 2022 were included. According to treatment methods those patients were divided into whole brain radiotherapy (WBRT) plus <i>EGFR</i>-TKI (WBRT group), stereotactic radiotherapy (SRT) plus <i>EGFR</i>-TKI (SRT group) and <i>EGFR</i>-TKI alone (TKI-only group). Propensity-score-matching (PSM) was performed to minimize the effect of possible confounding factors and to balance treatment groups.</p> Results <p>A total of 142 patients were included in this study. The median follow-up time was 22&#xa0;months (range, 3.0–43.0&#xa0;months). In the PSM cohort, the median intracranial progression free survival (iPFS) was 14, 30, 12&#xa0;months and the median overall survival (OS) was 27&#xa0;months, not reach and 33&#xa0;months in WBRT group, SRT group and TKI-only group, respectively. Compared with the other two groups, SRT group significantly improved iPFS and OS (<i>p</i> &lt; 0.05). And the local progression rate of intracranial lesions in SRT group was significantly reduced (p &lt; 0.05).</p> Conclusion <p>This study showed that SRT combined with TKI may improve iPFS and prolong survival in patients with <i>EGFR</i> mutations in BMs from NSCLC.</p>

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Efficacy analysis of brain radiotherapy in EGFR mutation non-small cell lung cancer with brain metastasis: a retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月8日

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  • Kaicheng Pan,
  • Bing Wang,
  • Xiao Xu,
  • Yi Tang,
  • Jiafeng Liang,
  • Shenglin Ma,
  • Bing Xia,
  • Lucheng Zhu

摘要

Objectives

Patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) are at a heightened risk of developing brain metastases (BM). EGFR-tyrosine kinase inhibitors (TKI) are standard treatment for EGFR-mutated NSCLC. However, the necessity and optimal approach of brain radiotherapy for NSCLC patients with EGFR mutation remain inconclusive. We aimed to answer these questions by retrospectively analyzing the efficacy of radiotherapy in patients with BM from NSCLC with EGFR mutations.

Methods

Patients with EGFR- mutant NSCLC and BMs who were diagnosed between January 1, 2018 and December 31, 2022 were included. According to treatment methods those patients were divided into whole brain radiotherapy (WBRT) plus EGFR-TKI (WBRT group), stereotactic radiotherapy (SRT) plus EGFR-TKI (SRT group) and EGFR-TKI alone (TKI-only group). Propensity-score-matching (PSM) was performed to minimize the effect of possible confounding factors and to balance treatment groups.

Results

A total of 142 patients were included in this study. The median follow-up time was 22 months (range, 3.0–43.0 months). In the PSM cohort, the median intracranial progression free survival (iPFS) was 14, 30, 12 months and the median overall survival (OS) was 27 months, not reach and 33 months in WBRT group, SRT group and TKI-only group, respectively. Compared with the other two groups, SRT group significantly improved iPFS and OS (p < 0.05). And the local progression rate of intracranial lesions in SRT group was significantly reduced (p < 0.05).

Conclusion

This study showed that SRT combined with TKI may improve iPFS and prolong survival in patients with EGFR mutations in BMs from NSCLC.