Clinical Research Papers:

Evaluation on efficacy and safety of the addition of X-knife therapy to gefitinib in NSCLC patients with symptomatic brain metastases

Linbo Cai _, Xiaoguang Qiu, Haihong Yang, Mingyao Lai, Changguo Shan, Weiping Hong, Juan Li, Longhui Luo, Ping Zhang and Lichao Wang

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Oncotarget. 2017; 8:57470-57476. https://doi.org/10.18632/oncotarget.10420

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Linbo Cai1, Xiaoguang Qiu2, Haihong Yang3, Mingyao Lai1, Changguo Shan1, Weiping Hong1, Juan Li1, Longhui Luo1, Ping Zhang1, Lichao Wang1

1Department of Oncology, Guangdong 999 Brain Hospital, Guangzhou, China

2Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University, Beijing, China

3Department of Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

Correspondence to:

Linbo Cai, email: [email protected]

Xiaoguang Qiu, email: [email protected]

Keywords: stereotactic radiosurgery, X-knife, EGFR, NSCLC, brain metastases

Received: February 23, 2016    Accepted: June 09, 2016    Published: July 06, 2016


Background: Stereotactic radiosurgery (SRS) is a widely used therapy for brain metastases(BMs) in Non-small cell lung cancer(NSCLC). However, its role in symptomatic patients with EGFR mutation remains unclear. We have retrospectively reviewed the clinical data of patients with symptomatic BMs whom received SRS as a salvage approach and concurrent gifitinib therapy.

Methods: Seven patients with primary NSCLC, symptomatic BMs, and EGFR mutation were identified in a retrospective review of patients treated with SRS using X-knife at Guangdong 999 Brain Hospital between 1 January 2012 and 31 August 2014. The median follow-up of these patients was 16 months. Image fusion technique was used to determine cumulative doses to targeted lesions, whole brain, and critical brain structures. Toxicities and complications were identified by clinical records.

Results: SRS(X-knife) was selected to be performed on seven patients (two males and five females) diagnosed with NSCLC and EGFR mutation due to the presence of encephaledema, compression of ventricles, or other complications. Neurological symptoms (such as paresis, aphasia, sensory and visual disturbances) were not present in any patients before or after SRS treatment, and the postoperative Karnofsky performance status(KPS) was improved in all patients. Median overall survival(OS) was 16 months and median progression free survival(PFS) was 10 months.

Conclusions: The improvement of KPS and survival were reliable by SRS(X-knife) with concurrent gifitinib therapy in NSCLC patients with symptomatic BMs, and EGFR mutation. Given the small sample size, further prospective studies with a greater number of patients are warranted to confirm our results.

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