ISSN: 1859 - 2872
Treatment of non-small cell lung cancer patients with brain metastasis harboring EGFR mutations by gefitinib combined brain radiosurgery
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Abstract
Objective: To evaluate the results of treatment for patients with non-small cell lung cancer (NSCLC) with brain metastasis (BM) harboring EGFR mutations using gefitinib combined with radiosurgery for brain damage. Subject and method: Prospective study, longitudinal follow-up, 35 patients with NSCLC with BM 1-3 lesions and EGFR mutations positive were treated by gefitinib combined brain radiosurgery. Patients are evaluated every 3 months or when symptoms of disease progression occur. The main criteria were progression-free survival (PFS), objective response rate (ORR) in the brain. Secondary criteria were disease control rate (DCR), overall survival (OS), adverse effects of gefitinib and brain radiosurgery. Result: The average age of patients was 63.34 years old. Chest pain and headache were the two most common symptoms, accounting for 62.9% and 65.7% respectively. There were 48.6% of patients with 1 BM, 17.1% with 2 BMs and 34.3% of patients with 3 BMs. There were 57.1% of patients carrying EGFR of exon 19 deletion mutation and 42.9% of patients with L858R point mutation on exon 21. The overall ORR was 71.4% and the overall DCR was 94.3%. Intracranial ORR was 80% with 34.3% complete response. Median PFS was 13 ± 0.92 months and median OS was 22 ± 5.8 months. There was no relationship between survival and the location of EGFR mutations and the number of brain metastasis. Adverse events related to gefitinib occurred in 54.3% of patients, the most common being rash with 37.2%. There were 3 patients with symptoms of increased intracranial pressure 48 hours after radiosurgery, 5 patients with epilepsy and 2 patients with dementia during post-treatment follow-up. Conclusion: Gefitinib combined with radiosurgery for brain metastasis is an effective and safe measure in patients with non-small cell lung cancer with brain metastasis harboring EGFR mutations.
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References
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