Clinical Research Papers:
Risk factors of brain metastasis during the course of EGFR-TKIs therapy for patients with EGFR-mutated advanced lung adenocarcinoma
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Xiaoyan Ma1,2,3,*, Hui Zhu2,*, Hongbo Guo4, Anqin Han2, Haiyong Wang2, Wang Jing2, Yan Zhang5, Li Kong2 and Jinming Yu2,3
1 School of Medicine and Life Sciences, University of Jinan, Jinan, Shandong, China
2 Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
3 Shandong Academy of Medical Sciences, Jinan, Shandong, China
4 Department of Thoracic Surgery, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
5 Department of Medical Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China
* These authors have contributed equally to this study
Jinming Yu, email:
Li Kong, email:
Keywords: brain metastasis, prophylactic cranial irradiation, risk factors, epidermal growth factor receptor, advanced lung adenocarcinoma
Received: April 11, 2016 Accepted: September 02, 2016 Published: September 08, 2016
Controversial value of prophylactic cranial irradiation (PCI) in NSCLC in terms of survival benefit prompted us to explore the possible risk factors for brain metastasis (BM) during the course of EGFR-TKIs therapy from EGFR-mutated advanced lung adenocarcinoma and identify the potential population most likely to benefit from PCI, because BM remains a therapeutically challenging issue. We retrospectively reviewed the records of 134 patients with EGFR-mutated advanced lung adenocarcinoma between 2008 and 2012. The cumulative incidence of BM was calculated by the Kaplan-Meier method, and Multivariate Cox regression analysis was used to assess the independent risk factors for BM. Thirty-four patients (34/134, 25.4%) developed BM during the course of EGFR-TKIs therapy. Moreover, the Multivariate analysis indicated that age ≤ 53 years (HR: 2.751, 95 % CI: 1.326-5.707; p = 0.007), serum carcinoembryonic antigen (CEA) ≥ 23 ng/mL (HR: 3.197, 95 % CI: 1.512-6.758; p = 0.002) and EGFR exon 21 point mutations (HR: 2.769, 95 % CI: 1.355-5.659; p= 0.005) were the independent high-risk factors for developing BM, which could offer important insights into the individualized treatment. Further studies are warranted to validate our findings.
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