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The Effect of Epidermal Growth Factor Receptor Mutation on Intracranial Progression-Free Survival of Non-Small Cell Lung Cancer Patients with Brain Metastasis Underwent Gamma Knife Radiosurgery

Brain Tumor Research and Treatment : BTRT 2020년 8권 2호 p.103 ~ 108
양승현, 김해유, 이선일, 진성진,
소속 상세정보
양승현 ( Yang Seung-Hyeon ) - Inje university College of Medicine Haeundae Paik Hospital Department of Neurosurgery
김해유 ( Kim Hae-Yu ) - Inje university College of Medicine Haeundae Paik Hospital Department of Neurosurgery
이선일 ( Lee Sun-Il ) - Inje university College of Medicine Haeundae Paik Hospital Department of Neurosurgery
진성진 ( Jin Seong-Jin ) - Inje University College of Medicine Haeundae Paik Hospital Gamma Knife Center

Abstract


Background: The aim of this study was to survey prognostic factors, particularly those focusing on epidermal growth factor receptor (EGFR) mutations, of patients with non-small cell lung cancer (NSCLC) after Gamma Knife Radiosurgery (GKRS) for metastatic brain tumors.

Methods: We retrospectively reviewed the medical records of 98 patients with NSCLC who underwent GKRS for brain metastases from August 2010 to July 2017. The primary endpoint was progression-free survival (PFS) of the intracranial disease. We analyzed variables such as age, sex, Karnofsky Performance Status, recursive partitioning analysis (RPA) class, smoking status, primary cancer pathology, EGFR mutations, and time to brain metastases as prognostic factors.

Results: The median overall survival (OS) of the patients was 16 months [95% confidence interval (CI), 13?21 months]. Median systemic PFS and intracranial PFS were 9 months (95% CI, 8?11 months) and 11 months (95% CI, 7?14 months), respectively. Kaplan-Meier survival analysis revealed that the patients with EGFR mutations had longer intracranial PFS than those without EGFR mutation (median intracranial PFS: 19 vs. 10 months with p=0.01) while they had no benefits in OS and systemic PFS. Furthermore, the patients harboring adenocarcinoma had longer OS (p<0.01) and intracranial PFS (p<0.01) and the patients with lower RPA class had longer OS (p=0.02) and intracranial PFS (p=0.03).

Conclusion: EGFR mutations, primary cancer pathology, and RPA class may be proposed as prognostic factors for intracranial PFS in NSCLC patients after GKRS for brain metastasis in this study.

키워드

Gamma knife radiosurgery; Epidermal growth factor receptor; Progression-free survival; Non-small cell lung cancer

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