Timing of Brain Radiation Therapy Impacts Outcomes in Patients with Non-small Cell Lung Cancer Who Develop Brain Metastases
Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes. Methods...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | zho |
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Chinese Anti-Cancer Association; Chinese Antituberculosis Association
2016-08-01
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| Series: | Chinese Journal of Lung Cancer |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.3779/j.issn.1009-3419.2016.08.04 |
| _version_ | 1819295108638441472 |
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| author | Yang WANG Jian FANG Jun NIE Ling DAI Weiheng HU Jie ZHANG Xiangjuan MA Jindi HAN Xiaoling CHEN Guangming TIAN Di WU Sen HAN Jieran LONG |
| author_facet | Yang WANG Jian FANG Jun NIE Ling DAI Weiheng HU Jie ZHANG Xiangjuan MA Jindi HAN Xiaoling CHEN Guangming TIAN Di WU Sen HAN Jieran LONG |
| author_sort | Yang WANG |
| collection | DOAJ |
| description | Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes. Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemotherapy or targeted therapy) were identified. The rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no significant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease specific-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group. Results Median overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 months vs 12.6 months; P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 months vs 3.0 months; P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy after the diagnosis of brain metastases as any line therapy improved the OS (20.0 months vs 10.7 months; P<0.01), whereas receiving TKI as first line therapy did not (17.9 months vs 15.2 months; P=0.289). Conclusion Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospective multi-central randomized study is imminently needed. |
| first_indexed | 2024-12-24T04:36:59Z |
| format | Article |
| id | doaj.art-c4630914c19f493f8f23d2f49d653615 |
| institution | Directory Open Access Journal |
| issn | 1009-3419 1999-6187 |
| language | zho |
| last_indexed | 2024-12-24T04:36:59Z |
| publishDate | 2016-08-01 |
| publisher | Chinese Anti-Cancer Association; Chinese Antituberculosis Association |
| record_format | Article |
| series | Chinese Journal of Lung Cancer |
| spelling | doaj.art-c4630914c19f493f8f23d2f49d6536152022-12-21T17:15:06ZzhoChinese Anti-Cancer Association; Chinese Antituberculosis AssociationChinese Journal of Lung Cancer1009-34191999-61872016-08-0119850851410.3779/j.issn.1009-3419.2016.08.04Timing of Brain Radiation Therapy Impacts Outcomes in Patients with
Non-small Cell Lung Cancer Who Develop Brain MetastasesYang WANG0Jian FANG1Jun NIE2Ling DAI3Weiheng HU4Jie ZHANG5Xiangjuan MA6Jindi HAN7Xiaoling CHEN8Guangming TIAN9Di WU10Sen HAN11Jieran LONG12Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education), the Second Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing 100142, ChinaBackground and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes. Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemotherapy or targeted therapy) were identified. The rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no significant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease specific-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group. Results Median overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 months vs 12.6 months; P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 months vs 3.0 months; P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy after the diagnosis of brain metastases as any line therapy improved the OS (20.0 months vs 10.7 months; P<0.01), whereas receiving TKI as first line therapy did not (17.9 months vs 15.2 months; P=0.289). Conclusion Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospective multi-central randomized study is imminently needed.http://dx.doi.org/10.3779/j.issn.1009-3419.2016.08.04Lung neoplasmsBrain metastasesBrain radiotherapyChemotherapyTargeted therapy |
| spellingShingle | Yang WANG Jian FANG Jun NIE Ling DAI Weiheng HU Jie ZHANG Xiangjuan MA Jindi HAN Xiaoling CHEN Guangming TIAN Di WU Sen HAN Jieran LONG Timing of Brain Radiation Therapy Impacts Outcomes in Patients with Non-small Cell Lung Cancer Who Develop Brain Metastases Chinese Journal of Lung Cancer Lung neoplasms Brain metastases Brain radiotherapy Chemotherapy Targeted therapy |
| title | Timing of Brain Radiation Therapy Impacts Outcomes in Patients with
Non-small Cell Lung Cancer Who Develop Brain Metastases |
| title_full | Timing of Brain Radiation Therapy Impacts Outcomes in Patients with
Non-small Cell Lung Cancer Who Develop Brain Metastases |
| title_fullStr | Timing of Brain Radiation Therapy Impacts Outcomes in Patients with
Non-small Cell Lung Cancer Who Develop Brain Metastases |
| title_full_unstemmed | Timing of Brain Radiation Therapy Impacts Outcomes in Patients with
Non-small Cell Lung Cancer Who Develop Brain Metastases |
| title_short | Timing of Brain Radiation Therapy Impacts Outcomes in Patients with
Non-small Cell Lung Cancer Who Develop Brain Metastases |
| title_sort | timing of brain radiation therapy impacts outcomes in patients with
non small cell lung cancer who develop brain metastases |
| topic | Lung neoplasms Brain metastases Brain radiotherapy Chemotherapy Targeted therapy |
| url | http://dx.doi.org/10.3779/j.issn.1009-3419.2016.08.04 |
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