Objective: The purpose of the study was to assess prognostic factors to predict overall survival(OS) and progression-free survival(PFS) in non-small-cell lung cancer(NSCLC) with brain metastasis(BM). Methods: From Nov...Objective: The purpose of the study was to assess prognostic factors to predict overall survival(OS) and progression-free survival(PFS) in non-small-cell lung cancer(NSCLC) with brain metastasis(BM). Methods: From November 2011 to March 2013, the clinical data of 31 NSCLC cases with BM treated with multiple modalities including brain radiotherapy alone, systemic chemotherapy, whole brain radiotherapy(WBRT) combined with tyrosine kinase inhibitor(TKIs). The efficacy and adverse reaction were evaluated after treatment. Results: In terms of intracranial lesions, the objective response rate(ORR) and the disease control rate(DCR) were 22.6% and 90.3%, respectively. As for systemic disease, ORR and DCR were 32.3% and 93.5%, respectively. The median time to progression-free survival(PFS) was 298 days(95% CI: 258.624–337.376 days), whereas in the epidermal growth factor receptor(EGFR) mutation patients was 331 days. Patients who received EGFR-TKIs combined with brain radiation had better response rate(RR) than those only brain radiation. Univariate analysis showed that the EGFR-mutations could predictive factors for PFS, and not to other clinical pathological features. The most common toxicities were rash and diarrhea, but all were well-tolerated. Conclusion: EGFR-mutations is the independent prognostic factors affecting the survival rates of NSCLC patients with BM. Through the clinical observation, icotinib combined with WBRT may be effective on brain metastases in NSCLC patients, and toxicities are tolerable, which worth further study.展开更多
文摘Objective: The purpose of the study was to assess prognostic factors to predict overall survival(OS) and progression-free survival(PFS) in non-small-cell lung cancer(NSCLC) with brain metastasis(BM). Methods: From November 2011 to March 2013, the clinical data of 31 NSCLC cases with BM treated with multiple modalities including brain radiotherapy alone, systemic chemotherapy, whole brain radiotherapy(WBRT) combined with tyrosine kinase inhibitor(TKIs). The efficacy and adverse reaction were evaluated after treatment. Results: In terms of intracranial lesions, the objective response rate(ORR) and the disease control rate(DCR) were 22.6% and 90.3%, respectively. As for systemic disease, ORR and DCR were 32.3% and 93.5%, respectively. The median time to progression-free survival(PFS) was 298 days(95% CI: 258.624–337.376 days), whereas in the epidermal growth factor receptor(EGFR) mutation patients was 331 days. Patients who received EGFR-TKIs combined with brain radiation had better response rate(RR) than those only brain radiation. Univariate analysis showed that the EGFR-mutations could predictive factors for PFS, and not to other clinical pathological features. The most common toxicities were rash and diarrhea, but all were well-tolerated. Conclusion: EGFR-mutations is the independent prognostic factors affecting the survival rates of NSCLC patients with BM. Through the clinical observation, icotinib combined with WBRT may be effective on brain metastases in NSCLC patients, and toxicities are tolerable, which worth further study.
