Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKI
PurposeEpidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy is the routine treatment for patients with metastatic non-small cell lung cancer (NSCLC) harboring positive EGFR mutations. Patients who undergo such treatment have reported cognitive decline during follow-up. This...
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Frontiers Media S.A.
2021-01-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2020.573512/full |
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| author | Beisheng Yang Chunli Luo Chunli Luo Min Yu Lin Zhou Bo Tao Biqiu Tang Ying Zhou Jiang Zhu Meijuan Huang Feng Peng Yongmei Liu Yong Xu Yan Zhang Xiaojuan Zhou Jianxin Xue Yanying Li Yongsheng Wang Zhiping Li You Lu Su Lui Youling Gong |
| author_facet | Beisheng Yang Chunli Luo Chunli Luo Min Yu Lin Zhou Bo Tao Biqiu Tang Ying Zhou Jiang Zhu Meijuan Huang Feng Peng Yongmei Liu Yong Xu Yan Zhang Xiaojuan Zhou Jianxin Xue Yanying Li Yongsheng Wang Zhiping Li You Lu Su Lui Youling Gong |
| author_sort | Beisheng Yang |
| collection | DOAJ |
| description | PurposeEpidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy is the routine treatment for patients with metastatic non-small cell lung cancer (NSCLC) harboring positive EGFR mutations. Patients who undergo such treatment have reported cognitive decline during follow-up. This study, therefore, aimed to evaluate brain structural changes in patients receiving EGFR-TKI to increase understanding of this potential symptom.MethodThe medical records of 75 patients with metastatic NSCLC (without brain metastasis or other co-morbidities) who received EGFR-TKI therapy from 2010 to 2017 were reviewed. The modified Scheltens Visual Scale and voxel-based morphometry were used to evaluate changes in white matter lesions (WML) and gray matter volume (GMV), respectively.ResultsThe WML scores were higher at the 12-month [8.65 ± 3.86; 95% confidence interval (CI), 1.60–2.35; p < 0.001] and 24-month follow-ups (10.11 ± 3.85; 95% CI, 2.98–3.87; p < 0.001) compared to baseline (6.68 ± 3.64). At the 24-month follow-up, the visual scores were also significantly higher in younger patients (3.89 ± 2.04) than in older patients (3.00 ± 1.78; p = 0.047) and higher in female patients (3.80 ± 2.04) than in male patients (2.73 ± 1.56; p = 0.023). Additionally, significant GMV loss was observed in sub-regions of the right occipital lobe (76.71 voxels; 95% CI, 40.740–112.69 voxels), left occipital lobe (93.48 voxels; 95% CI, 37.48–149.47 voxels), and left basal ganglia (37.57 voxels; 95% CI, 21.58–53.57 voxels) (all p < 0.005; cluster-level false discovery rate < 0.05).ConclusionsAn increase in WMLs and loss of GMV were observed in patients with metastatic NSCLC undergoing long-term EGFR-TKI treatment. This might reflect an unknown side-effect of EGFR-TKI treatment. Further prospective studies are necessary to confirm our findings. |
| first_indexed | 2024-12-20T09:22:11Z |
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| id | doaj.art-6f92995237534f28af530e69b46ec8a6 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-20T09:22:11Z |
| publishDate | 2021-01-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-6f92995237534f28af530e69b46ec8a62022-12-21T19:45:16ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-01-011010.3389/fonc.2020.573512573512Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKIBeisheng Yang0Chunli Luo1Chunli Luo2Min Yu3Lin Zhou4Bo Tao5Biqiu Tang6Ying Zhou7Jiang Zhu8Meijuan Huang9Feng Peng10Yongmei Liu11Yong Xu12Yan Zhang13Xiaojuan Zhou14Jianxin Xue15Yanying Li16Yongsheng Wang17Zhiping Li18You Lu19Su Lui20Youling Gong21Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaHuaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, ChinaHuaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Radiation Oncology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaHuaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, ChinaDepartment of Thoracic Oncology and State Key Laboratory of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, ChinaPurposeEpidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) therapy is the routine treatment for patients with metastatic non-small cell lung cancer (NSCLC) harboring positive EGFR mutations. Patients who undergo such treatment have reported cognitive decline during follow-up. This study, therefore, aimed to evaluate brain structural changes in patients receiving EGFR-TKI to increase understanding of this potential symptom.MethodThe medical records of 75 patients with metastatic NSCLC (without brain metastasis or other co-morbidities) who received EGFR-TKI therapy from 2010 to 2017 were reviewed. The modified Scheltens Visual Scale and voxel-based morphometry were used to evaluate changes in white matter lesions (WML) and gray matter volume (GMV), respectively.ResultsThe WML scores were higher at the 12-month [8.65 ± 3.86; 95% confidence interval (CI), 1.60–2.35; p < 0.001] and 24-month follow-ups (10.11 ± 3.85; 95% CI, 2.98–3.87; p < 0.001) compared to baseline (6.68 ± 3.64). At the 24-month follow-up, the visual scores were also significantly higher in younger patients (3.89 ± 2.04) than in older patients (3.00 ± 1.78; p = 0.047) and higher in female patients (3.80 ± 2.04) than in male patients (2.73 ± 1.56; p = 0.023). Additionally, significant GMV loss was observed in sub-regions of the right occipital lobe (76.71 voxels; 95% CI, 40.740–112.69 voxels), left occipital lobe (93.48 voxels; 95% CI, 37.48–149.47 voxels), and left basal ganglia (37.57 voxels; 95% CI, 21.58–53.57 voxels) (all p < 0.005; cluster-level false discovery rate < 0.05).ConclusionsAn increase in WMLs and loss of GMV were observed in patients with metastatic NSCLC undergoing long-term EGFR-TKI treatment. This might reflect an unknown side-effect of EGFR-TKI treatment. Further prospective studies are necessary to confirm our findings.https://www.frontiersin.org/articles/10.3389/fonc.2020.573512/fullnon-small cell lung cancerepidermal growth factor receptor-tyrosine kinase inhibitorwhite matter lesiongray matterMRI |
| spellingShingle | Beisheng Yang Chunli Luo Chunli Luo Min Yu Lin Zhou Bo Tao Biqiu Tang Ying Zhou Jiang Zhu Meijuan Huang Feng Peng Yongmei Liu Yong Xu Yan Zhang Xiaojuan Zhou Jianxin Xue Yanying Li Yongsheng Wang Zhiping Li You Lu Su Lui Youling Gong Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKI Frontiers in Oncology non-small cell lung cancer epidermal growth factor receptor-tyrosine kinase inhibitor white matter lesion gray matter MRI |
| title | Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKI |
| title_full | Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKI |
| title_fullStr | Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKI |
| title_full_unstemmed | Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKI |
| title_short | Changes of Brain Structure in Patients With Metastatic Non-Small Cell Lung Cancer After Long-Term Target Therapy With EGFR-TKI |
| title_sort | changes of brain structure in patients with metastatic non small cell lung cancer after long term target therapy with egfr tki |
| topic | non-small cell lung cancer epidermal growth factor receptor-tyrosine kinase inhibitor white matter lesion gray matter MRI |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2020.573512/full |
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