Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis

Abstract Purpose Epidermal growth factor receptor (EGFR)-mutant lung cancers have a high risk of developing brain metastases (BM). Whole brain radiotherapy (WBRT), local radiotherapy, and WBRT + Boost are frequently used for treatment of BM. This retrospective study aimed to evaluate the difference...

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Autores principales:	Guangchuan Deng, Yingyun Zhang, Jiaojiao Ke, Qi Wang, Hongyue Qin, Jianbin Li, Zhenxiang Li
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	EGFR-mutant Lung adenocarcinoma Brain metastasis Lung-molGPA Brain radiotherapy Medicine R
Acceso en línea:	https://doaj.org/article/542c89321a234cef84d03971ddc208b9
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spelling	oai:doaj.org-article:542c89321a234cef84d03971ddc208b92021-12-05T12:05:54ZEffect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis10.1186/s12967-021-03161-11479-5876https://doaj.org/article/542c89321a234cef84d03971ddc208b92021-11-01T00:00:00Zhttps://doi.org/10.1186/s12967-021-03161-1https://doaj.org/toc/1479-5876Abstract Purpose Epidermal growth factor receptor (EGFR)-mutant lung cancers have a high risk of developing brain metastases (BM). Whole brain radiotherapy (WBRT), local radiotherapy, and WBRT + Boost are frequently used for treatment of BM. This retrospective study aimed to evaluate the difference in efficacy of these radiotherapy modes in patients with EGFR-mutant lung adenocarcinoma with BMs. Further, we determined the optimal radiotherapy regimen for patients based on Lung-molGPA. Methods and materials We retrospectively enrolled 232 patients with EGFR-mutant lung adenocarcinoma with BMs. Patients were divided into three groups based on the different modes of brain radiotherapy: WBRT group, local radiotherapy group, and WBRT + Boost group. Graded prognostic assessment for lung cancer using molecular markers (Lung molGPA), overall survival (OS), and intracranial progression-free survival (iPFS) were calculated. Kaplan–Meier was used to compare iPFS and OS in different groups. Results The median OS for the WBRT (n = 84), local radiotherapy (n = 65), and WBRT + Boost (n = 83) cohorts was 32.8, 59.1, and 41.7 months, respectively (P = 0.0002). After stratification according to the Lung-molGPA score, the median OS for the WBRT (n = 56), local radiotherapy (n = 19), and WBRT + Boost (n = 28) cohorts was 32.5, 30.9, and 30.8 months, respectively, in subgroup with score 1–2 (P = 0.5097). In subgroup with score 2.5–4, the median OS for the WBRT (n = 26), local radiotherapy (n = 45), and WBRT + Boost (n = 54) cohorts was 32, 68.4, and 51 months, respectively (P = 0.0041). Conclusion The present study showed that in patients with EGFR-mutant lung adenocarcinoma with BM, local radiotherapy and WBRT + Boost perform similarly well both in the subgroups with low and high scores of Lung-molGPA. Considering the side effect caused by whole brain radiotherapy, we recommended local radiotherapy as optimal brain radiation mode for those subtype lung cancer patients.Guangchuan DengYingyun ZhangJiaojiao KeQi WangHongyue QinJianbin LiZhenxiang LiBMCarticleEGFR-mutantLung adenocarcinomaBrain metastasisLung-molGPABrain radiotherapyMedicineRENJournal of Translational Medicine, Vol 19, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	EGFR-mutant Lung adenocarcinoma Brain metastasis Lung-molGPA Brain radiotherapy Medicine R
spellingShingle	EGFR-mutant Lung adenocarcinoma Brain metastasis Lung-molGPA Brain radiotherapy Medicine R Guangchuan Deng Yingyun Zhang Jiaojiao Ke Qi Wang Hongyue Qin Jianbin Li Zhenxiang Li Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis
description	Abstract Purpose Epidermal growth factor receptor (EGFR)-mutant lung cancers have a high risk of developing brain metastases (BM). Whole brain radiotherapy (WBRT), local radiotherapy, and WBRT + Boost are frequently used for treatment of BM. This retrospective study aimed to evaluate the difference in efficacy of these radiotherapy modes in patients with EGFR-mutant lung adenocarcinoma with BMs. Further, we determined the optimal radiotherapy regimen for patients based on Lung-molGPA. Methods and materials We retrospectively enrolled 232 patients with EGFR-mutant lung adenocarcinoma with BMs. Patients were divided into three groups based on the different modes of brain radiotherapy: WBRT group, local radiotherapy group, and WBRT + Boost group. Graded prognostic assessment for lung cancer using molecular markers (Lung molGPA), overall survival (OS), and intracranial progression-free survival (iPFS) were calculated. Kaplan–Meier was used to compare iPFS and OS in different groups. Results The median OS for the WBRT (n = 84), local radiotherapy (n = 65), and WBRT + Boost (n = 83) cohorts was 32.8, 59.1, and 41.7 months, respectively (P = 0.0002). After stratification according to the Lung-molGPA score, the median OS for the WBRT (n = 56), local radiotherapy (n = 19), and WBRT + Boost (n = 28) cohorts was 32.5, 30.9, and 30.8 months, respectively, in subgroup with score 1–2 (P = 0.5097). In subgroup with score 2.5–4, the median OS for the WBRT (n = 26), local radiotherapy (n = 45), and WBRT + Boost (n = 54) cohorts was 32, 68.4, and 51 months, respectively (P = 0.0041). Conclusion The present study showed that in patients with EGFR-mutant lung adenocarcinoma with BM, local radiotherapy and WBRT + Boost perform similarly well both in the subgroups with low and high scores of Lung-molGPA. Considering the side effect caused by whole brain radiotherapy, we recommended local radiotherapy as optimal brain radiation mode for those subtype lung cancer patients.
format	article
author	Guangchuan Deng Yingyun Zhang Jiaojiao Ke Qi Wang Hongyue Qin Jianbin Li Zhenxiang Li
author_facet	Guangchuan Deng Yingyun Zhang Jiaojiao Ke Qi Wang Hongyue Qin Jianbin Li Zhenxiang Li
author_sort	Guangchuan Deng
title	Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis
title_short	Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis
title_full	Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis
title_fullStr	Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis
title_full_unstemmed	Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis
title_sort	effect of brain radiotherapy strategies on prognosis of patients with egfr-mutant lung adenocarcinoma with brain metastasis
publisher	BMC
publishDate	2021
url	https://doaj.org/article/542c89321a234cef84d03971ddc208b9
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Effect of brain radiotherapy strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with brain metastasis

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