EGFR/ALK改变对全脑放射治疗肺腺癌软脑膜转移的预后影响。

IF 4.2 3区 医学 Q2 ONCOLOGY
Clinical & Experimental Metastasis Pub Date : 2023-10-01 Epub Date: 2023-07-19 DOI:10.1007/s10585-023-10225-7
Hidekazu Oyoshi, Hidenari Hirata, Yasuhiro Hirano, Sadamoto Zenda, Yuzheng Zhou, Kento Tomizawa, Takeshi Fujisawa, Masaki Nakamura, Hidehiro Hojo, Atsushi Motegi, Shun-Ichiro Kageyama, Yoshitaka Zenke, Koichi Goto, Shunichi Ishihara, Shinji Naganawa, Tetsuo Akimoto
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引用次数: 0

摘要

接受全脑放疗(WBRT)治疗肺腺癌软脑膜转移(LM)患者的预后和预后因素尚未确定。特别是,EGFR突变和ALK重排对生存率的影响尚不清楚。这项回顾性研究评估了接受WBRT治疗LM的患者的预后和预后因素。我们评估了2013年6月至2021年6月期间在我们机构接受WBRT治疗肺腺癌LM的80名连续患者的WBRT启动后的总生存率(OS)和临床变量。中位随访5.2个月(0.5-56.5个月)后,中位OS为6.2个月(95%CI 4.4-12.4)。在80名患者中,51名被归类为EGFR/ALK突变型(EGFR:44;ALK:6;两者均为1),29名为野生型。EGFR/ALK突变体与野生型患者的中位OS分别为10.4(95%CI 5.9-20.9)和3.8(95%CI 2.5-7.7)个月(HR = 0.49,P = 0.0063)。多因素分析表明EGFR/ALK改变(HR = 0.54,P = 0.021)和东部肿瘤协作组绩效状态(ECOG PS)为0-1(HR = 0.25,P
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prognostic impact of EGFR/ALK alterations in leptomeningeal metastasis from lung adenocarcinoma treated with whole-brain radiotherapy.

Prognostic impact of EGFR/ALK alterations in leptomeningeal metastasis from lung adenocarcinoma treated with whole-brain radiotherapy.

The prognosis and prognostic factors of patients receiving whole-brain radiotherapy (WBRT) for leptomeningeal metastasis (LM) from lung adenocarcinoma have not been established. Particularly, the impact of EGFR mutations and ALK rearrangements on survival remains unclear. This retrospective study evaluated the prognosis and prognostic factors of patients receiving WBRT for LM. We evaluated overall survival (OS) from WBRT initiation and clinical variables in 80 consecutive patients receiving WBRT for LM from lung adenocarcinoma at our institution between June 2013 and June 2021. After a median follow-up of 5.2 (range 0.5-56.5) months, the median OS was 6.2 months (95% CI 4.4-12.4). Of the 80 patients, 51 were classified as EGFR/ALK mutant (EGFR: 44; ALK: 6; both: 1) and 29 as wild-type. The median OS was 10.4 (95% CI 5.9-20.9) versus 3.8 (95% CI 2.5-7.7) months in the EGFR/ALK-mutant versus wild-type patients (HR = 0.49, P = 0.0063). Multivariate analysis indicated that EGFR/ALK alterations (HR = 0.54, P = 0.021) and Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-1 (HR = 0.25, P < 0.001) were independent factors associated with favorable OS. Among the patients who underwent brain MRI before and after WBRT, intracranial progression-free survival was longer in the 26 EGFR/ALK-mutant than 13 wild-type patients (HR = 0.31, P = 0.0039). Although the prognosis of patients receiving WBRT for LM remains poor, EGFR/ALK alterations and good ECOG PS may positively impact OS in those eligible for WBRT.

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来源期刊
CiteScore
7.80
自引率
5.00%
发文量
55
审稿时长
12 months
期刊介绍: The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.
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