GAMMA KNIFE STEREOTACTIC RADIOSURGERY COMBINED WITH TARGETED THERAPY FOR BRAIN METASTASES IN NON-SMALL CELL LUNG CANCER WITH EGFR GENE MUTATIONS
Tóm tắt
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Abstract
Objectives: Our study aims to evaluate the outcome of Gamma Knife radiosurgery combined TKIs for brain metastasis of non-small cell lung cancer with EGFR gene mutations.
Methods: We analyzed 35 patients with brain metastatic non-small cell lung cancer with EGFR gene mutations from July 2019 to May 2024. Selected patients have brain metastases from 1 to 10 tumors, size ≤ 3cm, KPS score ≥ 60, EGFR gene mutation, first-generation TKI treatment. Patients were treated by stereotactic radiosurgery using Leksell Gamma Knife ICON unit (Elekta AB) with dose of 20 – 24, 18 – 20Gy for lesions measuring < 2, 2.1 – 3 cm, respectively. Patients take 1st generation TKIs (erlotinib or gefitinib) 1 tablet per day. Patients were assessed for clinical symptoms and imaging response according to RANO criteria at 6, 12 months and survival outcomes.
Results: In our study, cerebral progression-free survival rate at 12 months was 100%, 24 months was 65,6%. Overall survival rate at 12 months was 84%, 24 months was 57,9%, overall survival time was 28 ± 3,7 months.
Conclusion: Combination Gamma Knife radiosurgery with TKIs is an effective treatment for brain metastasis of non-small cell lung cancer with EGFR gene mutations.
Từ khóa
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Keywords
Radiosurgery; brain metastases; non-small cell lung cancer; EGFR gene mutations; TKIs
Tài liệu tham khảo (References)
- GOLOBOCAN. Incidence, Mortality and Prevalence by cancer site.
- Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. Jul 15 2004;22(14):2865-72. doi:10.1200/JCO.2004.12.149
- Ge M, Zhuang Y, Zhou X, Huang R, Liang X, Zhan Q. High probability and frequency of EGFR mutations in non-small cell lung cancer with brain metastases. Journal of neuro-oncology. Nov 2017;135(2):413-418. doi:10.1007/s11060-017-2590-x
- Zhuang H, Shi S, Chang JY. Treatment modes for EGFR mutations in patients with brain metastases from non-small cell lung cancer: controversy, causes, and solutions. Translational lung cancer research. Aug 2019;8(4):524-531. doi:10.21037/tlcr.2019.07.03
- Yomo S, Oda K. Impacts of EGFR-mutation status and EGFR-TKI on the efficacy of stereotactic radiosurgery for brain metastases from non-small cell lung adenocarcinoma: A retrospective analysis of 133 consecutive patients. Lung cancer. May 2018;119:120-126. doi:10.1016/j.lungcan.2018.03.013
- AE D, J T, MN M, et al. Clinical Outcomes of Non-Small Cell Lung Cancer Brain Metastases Treated With Stereotactic Radiosurgery and Immune Checkpoint Inhibitors, EGFR Tyrosine Kinase Inhibitors, Chemotherapy and Immune Checkpoint Inhibitors, or Chemotherapy Alone. Int J Radiat OncolBiolPhys. 2021;111(3, Supplement):567.
- Magnuson WJ, Lester-Coll NH, Wu AJ, et al. Management of Brain Metastases in Tyrosine Kinase Inhibitor-Naive Epidermal Growth Factor Receptor-Mutant Non-Small-Cell Lung Cancer: A Retrospective Multi-Institutional Analysis. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. Apr 1 2017;35(10):1070-1077. doi:10.1200/JCO.2016.69.7144
