J Korean Neurosurg Soc.  2015 Sep;58(3):205-210. 10.3340/jkns.2015.58.3.205.

Effects of an Epithelial Growth Factor Receptor-Tyrosine Kinase Inhibitor Add-on in Stereotactic Radiosurgery for Brain Metastases Originating from Non-Small-Cell Lung Cancer

• Kim HJ
• Kim WS
• Kwon DH
• Cho YH
• Choi CM

• KMID: 2191362
• DOI: http://doi.org/10.3340/jkns.2015.58.3.205

Abstract

OBJECTIVE
This study was aimed at optimizing the treatment of non-small-cell lung cancer (NSCLC) patients who are candidates for stereotactic radiosurgery (SRS) for brain metastases and harbor activating epithelial growth factor receptor (EGFR) mutations.
METHODS
We retrospectively reviewed the medical records from 2005 to 2010 of NSCLC patients with brain metastases harboring an activating EGFR mutation. Patients who received a combination therapy of SRS and EGFR-tyrosine kinase inhibitor (TKI) for brain metastases and those who received SRS without EGFR-TKI were compared. The primary endpoint was progression-free survival (PFS) of the brain metastases.
RESULTS
Thirty-one patients were eligible for enrolment in this study (SRS with TKI, 18; SRS without TKI, 13). Twenty-two patients (71.0%) were women and the median overall age was 56.0 years. PFS of brain lesions was not significantly prolonged in SRS with TKI treatment group than in SRS without TKI group (17.0 months vs. 9.0 months, p=0.45). Local tumor control rate was 83.3% in the combination therapy group, and 61.5% in the SRS monotherapy group (p=0.23). There were no severe adverse events related with treatment in both groups.
CONCLUSIONS
Therapeutic outcome of concurrent SRS and TKI treatment was not superior to SRS monotherapy, however, there was no additive adverse events related with combined treatment.

Keyword

Radiosurgery; Neoplasm metastasis; Epiderrmal growth factor; Non-small-cell lung; Carcinoma

MeSH Terms

Brain*
Disease-Free Survival
Female
Humans
Lung Neoplasms*
Lung*
Medical Records
Neoplasm Metastasis*
Phosphotransferases*
Radiosurgery*
Retrospective Studies
Phosphotransferases

Figure

• 

  Fig. 1 Flow chart of enrolled patients. SRS : stereotactic radiosurgery, BM : brain metastasis, NSCLC : non-small-cell lung cancer, EGFR : epithelial growth factor receptor, TKI : tyrosine kinase inhibitor.

• 

  Fig. 2 Kaplan-Meier analysis of progression-free survival and overall survival. TKI : tyrosine kinase inhibitor.

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