Thoracic Radiotherapy and Radiation Time Would Affect the Efficacy of Advanced Non-Small Cell Lung Cancer for Patients Who Responded to TKIs Treatment

IF 3.9 3区医学 Q2 ONCOLOGY

Clinical lung cancer Pub Date : 2026-03-01 Epub Date: 2026-01-10 DOI:10.1016/j.cllc.2025.12.009

Ma Jinbo, Li Cheng, Wang Xiao, Zhang Pengfei, Ma Xiaoyan, Kan Hongxing, Zhang Wei

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引用次数: 0

Abstract

Purpose

This trial aimed to investigate the difference in treatment efficacy of thoracic radiotherapy before and after thoracic progression during treatment with EGFR-TKI to determine the optimal timing of consolidation thoracic radiotherapy.

Materials and Methods

815 patients with histologically confirmed advanced NSCLC with EGFR mutation received 1-3 generation EGFR-TKIs or EGFR-TKIs treatment plus thoracic radiotherapy from May 2017 to May 2020.. For patients who received thoracic radiotherapy, 196 received thoracic radiotherapy before thoracic progression, and 244 patients received thoracic radiotherapy after thoracic progression. Kaplan-Meier analysis and log-rank test were used to compare survival differences for radiotherapy sequences.

Results

There was a significant statistical difference in the median OS[mOS: 31.8 vs 18.4 months, HR=0.60(0.479, 0.952), P=0.000] and PFS[mPFS: 22.6 vs 14.0 months, HR=0.60(0.485, 0.736), P=0.000] between TKIs plus radiotherapy group and TKIs group. For patients who received thoracic radiotherapy, 5-year OS rates were 43.6% and 28.2% in the pre-progression and post-progression groups, respectively (HR=0.67, P=0.047). The median OS was 33.7 months (22.10-38.1) and 27.8 months (19.16-27.90) for the two groups, respectively. 5-year progression-free survival rates were 71.8% and 54.5% in the pre-progression group and post-progression group, respectively (HR=0.73,P=0.043). The median PFS was 27.4 months (23.48-31.25) and 19.2 months (15.94-22.53) for the two groups, respectively.

Conclusion

It indicated that advanced stage NSCLC with positive EGFR mutation had better long-term survival if patients underwent thoracic radiotherapy before thoracic progression in the TKIs treatment.

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胸部放疗和放疗时间对TKIs治疗有应答的晚期非小细胞肺癌疗效有影响。

目的：本试验旨在探讨EGFR-TKI治疗期间胸部进展前后胸部放疗治疗效果的差异，以确定胸部巩固放疗的最佳时机。材料与方法：2017年5月至2020年5月，815例组织学证实的EGFR突变晚期NSCLC患者接受了1-3代EGFR- tkis或EGFR- tkis治疗加胸部放疗。在接受胸部放疗的患者中，196例患者在胸部进展前接受了胸部放疗，244例患者在胸部进展后接受了胸部放疗。采用Kaplan-Meier分析和log-rank检验比较放疗序列的生存差异。结果：TKIs加放疗组与TKIs组患者的中位OS[mOS: 31.8 vs 18.4个月，HR=0.60(0.479, 0.952)， P=0.000]和PFS[mPFS: 22.6 vs 14.0个月，HR=0.60(0.485, 0.736)， P=0.000]差异有统计学意义。对于接受胸部放疗的患者，进展前组和进展后组的5年OS分别为43.6%和28.2% （HR=0.67， P=0.047）。两组患者的中位OS分别为33.7个月（22.10-38.1）和27.8个月（19.16-27.90）。进展前组和进展后组5年无进展生存率分别为71.8%和54.5% （HR=0.73，P=0.043）。两组患者的中位PFS分别为27.4个月（23.48 ~ 31.25）和19.2个月（15.94 ~ 22.53）。结论：EGFR阳性突变的晚期NSCLC患者在TKIs治疗前进行胸部放疗可获得更好的长期生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical lung cancer 医学-肿瘤学

CiteScore

7.00

自引率

2.80%

发文量

159

审稿时长

24 days

期刊介绍： Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.