Jim X Leng, Chang Su, David J Carpenter, Warren Floyd, Eugene Vaios, Rachel Shenker, Peter G Hendrickson, Will Giles, Trey Mullikin, Scott R Floyd, John P Kirkpatrick, Michelle Green, Zachary J Reitman
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引用次数: 0
摘要
目的：研究TP53变异是否与非小细胞肺癌（NSCLC）脑转移瘤（BMs）立体定向放射外科手术（SRS）后的总生存率和局部控制率相关：方法：对2015年1月1日至2020年12月12日期间因NSCLC脑转移接受SRS初始疗程的患者进行回顾性鉴定。通过卡普兰-梅耶法估算总生存期和颅内局部进展自由度（FFLIP）。Cox模型评估了TP53变异状态（致病变异，PV；未检测到变异，ND）。结果：255名患者接受了TP53分子分析，其中144人（56%）有TP53变异。中位随访时间为 11.6 个月。不同 TP53 状态的 OS 无明显差异。观察到PV（95% CI 62.9个月-NR）与ND患者（95% CI 29.4个月-NR；P=0.06）相比，FFLIP呈上升趋势。TP53变异患者的FFLIP优于TP53 ND患者：在患有BMs的NSCLC患者中，TP53状态与SRS后FFLIP之间的潜在关联值得在更大的前瞻性队列中进一步研究。
Impact of TP53 mutations on brain metastasis control in non-small cell lung cancer patients undergoing stereotactic radiosurgery.
Purpose: To investigate whether TP53 variants may be correlated with overall survival and local control following stereotactic radiosurgery (SRS) for brain metastases (BMs) from non-small cell lung cancer (NSCLC).
Methods: Patients undergoing an initial course of SRS for NSCLC brain metastases between 1/2015 and 12/2020 were retrospectively identified. Overall survival and freedom from local intracranial progression (FFLIP) were estimated via Kaplan-Meier method. Cox models assessed TP53 variant status (pathogenic variant, PV; variant not detected, ND).
Results: 255 patients underwent molecular profiling for TP53, among whom 144 (56%) had a TP53 PV. Median follow-up was 11.6 months. OS was not significantly different across TP53 status. A trend toward superior FFLIP was observed for PV (95% CI 62.9 months-NR) versus ND patients (95% CI 29.4 months-NR; p=0.06). Superior FFLIP was observed for patients with one TP53 variant versus those with TP53 ND.
Conclusion: Among NSCLC patients with BMs, the potential association between TP53 status and post-SRS FFLIP warrants further investigation in a larger prospective cohort.
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