Clinical efficacy of erlotinib combined with concurrent whole brain radiotherapy in treatment of multiple brain metastases from EGFR-mutant lung adenocarcinoma

Abstract

Objective To investigate the clinical efficacy and safety of erlotinib combined with concurrent whole brain radiotherapy (WBRT) in the treatment of multiple brain metastases from lung adenocarcinoma, and to provide objective evidence for improving the prognosis of patients. Methods Eighty-nine patients with brain metastases from epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma who were admitted to our hospital were divided into experimental group (n=45) and control group (n=44) according to the different treatment methods. The experimental group received erlotinib combined with concurrent WBRT. The control group received oral administration of erlotinib alone for 28 d and then received concurrent WBRT. The survival rates were calculated using the Kaplan-Meier method and analyzed using the log-rank test. The other data were analyzed by the chi-square test. Results The objective response rate was significantly higher in the experimental group than in the control group (78% vs. 55%, P=0.000). The median progression-free survival (PFS) time in the experimental group and the control group were 9.1 months (95% confidence interval[CI]: 5.18-12.47) and 5.6 months (95%CI: 3.46-9.12), respectively (P=0.078). The median overall survival (OS) time in the experimental group and the control group were 14.3 months (95%CI: 9.51-17.82) and 9.7 months (95%CI: 4.59-16.74), respectively (P=0.032). The incidence rates of headache and dizziness were significantly higher in the experimental group than in the control group (38% vs. 14%, P=0.029; 33% vs. 9%, P=0.020). Conclusions In the treatment of multiple brain metastases from EGFR-mutant lung adenocarcinoma, erlotinib combined with concurrent WBRT is superior to erlotinib alone. The combination therapy increases PFS and OS time of the nervous system in patients. Key words: Neoplasms metastasis, brain/radiotherapy; Neoplasms metastasis, brain/targeted therapy; Treatment outcome