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Background <p>Brain metastases (BMs) are a common and fatal consequence in patients with advanced malignancies. Mutations happening in the epidermal growth factor receptor (EGFR) are associated with an elevated risk BMs, occurring in approximately 20–40% of patients. This study evaluates the safety and efficacy of different radiotherapy (RT) modalities in patients with EGFR-mutant lung cancer brain metastases. </p> Method <p>This study was conducted according to the PRISMA guideline. A comprehensive search was conducted on PubMed, Embase, Web of Science, and Scopus, until 13 March 2024. Stata v.17 was used for statistical analysis.</p> Result <p>A total of 57 studies involving 4614 patients were analyzed, with a female predominance of 59.55% and a mean age of 50–70 years. The 6-month overall survival (OS) rate was 94% [95% CI 91–96%], 81% [95% CI 78– 84%] at 1-year, 55% [95% CI 50–60%] at 2-year, 37% [95% CI 32–42%] at 3-year, decreasing to 21% [95% CI 16–26%] at 5 years. Progression-free survival (PFS) rates were 84% [95% CI 79–89%] at 6 months and 20% [95% CI 14–26%] at 3 years. Meta-regression analysis indicated that a higher number of metastases, Karnofsky performance status below 80, and an ECOG score over one were significantly linked to OS outcomes. </p> Conclusion <p>RT significantly improves survival outcomes in patients with EGFR-mutant brain metastases. However, the combination of RT with targeted therapies, such as tyrosine kinase inhibitors (TKIs), appears to offer more favorable outcomes.</p>

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The effect of radiotherapy on patients with EGFR-driven lung cancer brain metastasis: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月7日

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  • Mohammad Amin Habibi,
  • Farhang Rashidi,
  • Pourya Delbari,
  • Bardia Hajikarimloo,
  • Seyed Hesam Hojjat,
  • Sana Kazemivand,
  • Sahar Fathi Tavani,
  • Amirmohammad Bahri,
  • Mohammad Shahir Eftekhar,
  • Hossein Gandomkar,
  • Ibrahim Mohammadzadeh

摘要

Background

Brain metastases (BMs) are a common and fatal consequence in patients with advanced malignancies. Mutations happening in the epidermal growth factor receptor (EGFR) are associated with an elevated risk BMs, occurring in approximately 20–40% of patients. This study evaluates the safety and efficacy of different radiotherapy (RT) modalities in patients with EGFR-mutant lung cancer brain metastases.

Method

This study was conducted according to the PRISMA guideline. A comprehensive search was conducted on PubMed, Embase, Web of Science, and Scopus, until 13 March 2024. Stata v.17 was used for statistical analysis.

Result

A total of 57 studies involving 4614 patients were analyzed, with a female predominance of 59.55% and a mean age of 50–70 years. The 6-month overall survival (OS) rate was 94% [95% CI 91–96%], 81% [95% CI 78– 84%] at 1-year, 55% [95% CI 50–60%] at 2-year, 37% [95% CI 32–42%] at 3-year, decreasing to 21% [95% CI 16–26%] at 5 years. Progression-free survival (PFS) rates were 84% [95% CI 79–89%] at 6 months and 20% [95% CI 14–26%] at 3 years. Meta-regression analysis indicated that a higher number of metastases, Karnofsky performance status below 80, and an ECOG score over one were significantly linked to OS outcomes.

Conclusion

RT significantly improves survival outcomes in patients with EGFR-mutant brain metastases. However, the combination of RT with targeted therapies, such as tyrosine kinase inhibitors (TKIs), appears to offer more favorable outcomes.