医学
肺癌
内科学
肿瘤科
酪氨酸激酶
埃罗替尼
放射外科
外科
癌症
表皮生长因子受体
受体
放射治疗
作者
Hung-Ruei Liao,Chi‐Lu Chiang,Ching-Hui Shen,Ching-Jen Chen,Huai‐Che Yang,Hsiu-Mei Wu,Yung‐Hung Luo,Yong-Sin Hu,Lin Cc,Wen‐Yuh Chung,Chung‐Wai Shiau,Wan‐Yuo Guo,David Hung-Chi Pan,Cheng‐Chia Lee
出处
期刊:Research Square - Research Square
日期:2022-05-17
标识
DOI:10.21203/rs.3.rs-1647440/v1
摘要
Abstract 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
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