Clinical Studies on conformal radiotherapy combined with epidermal growth factor receptor-tyrosine kinase inhibitor in second-line treatment of non-small cell lung cancer

Ji-Ying Wang,Yong Cai,Chong Bai

doi:10.4314/tjpr.v15i5.22

Abstract

Purpose: To study the effect of conformal radiotherapy combined with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in the second-line treatment of non-small cell lung cancer (NSCLC). Methods: A total of 316 patients attending Shanghai Pulmonary Hospital affiliated to Tongji University, were divided into two groups: 106 patients were treated with conformal radiotherapy combined with EGFR-TKI (gefitinib, 250 mg/day; or erlotinib, 150 mg/day), while 210 patients were treated with EGFRTKI alone. Some factors, including adverse reactions (AR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and one-year and two-year survival rate, were evaluated. Results: No obvious difference was observed in AR between the two groups ( p > 0.05). In the combination therapy group, complete response (CR) was 5 cases, partial response (PR) 43 cases, and stable disease (SD) 47 cases, progressive disease (PD) was 11 cases, response rate (RR) was 45.3 %, and DCR 89.6 %. Median PFS in the combination therapy group and targeted therapy group was 6.5 and 5.0 months, respectively. On the other hand, median OS in the combination therapy group and targeted group was 14.1 and 12.6 months, respectively. One-year survival rate of the combination therapy group and EGFR-TKI group was 60.3 and 50.0 %, respectively, while the two-year survival rate was 26.3 and 19.0 %, respectively. Conclusion: Conformal radiotherapy combined with EGFR-TKI can be used as an effective second-line treatment for NSCLC. Keywords: Non-small cell lung cancer, Epidermal growth factor receptor tyrosine kinase inhibitor, Conformal radiotherapy, Targeted therapy, Survival rate

Highlights

Lung cancer is the primary cause of cancer deaths
The subjects were divided randomly into two groups: 106 patients were treated with conformal radiotherapy combined with Epidermal growth factor receptor (EGFR)-TKI, tagged combination therapy group), while 210 patients were treated with EGFR-TKI alone, i.e., EGFR-TKI monotherapy group
Our results revealed that proportion of males was higher than females by nearly 25 %, and nearly 30 % of the patients with ECOG PS score = 2 points received two and three-line treatment, suggesting that after recurrence or metastasis after chemotherapy, the patients’ PS score decreased significantly

Summary

Introduction

Lung cancer is the primary cause of cancer deaths. In the last 30 years, the incidence of lung cancer in China has increased significantly, especially in females [1,2]. Non-small cell lung cancer (NSCLC) accounts for 80 – 85 % of lung cancers [3]. More than two-thirds of NSCLC patients do not opt for radical surgery when definite diagnosis is made [4]. Epidermal growth factor receptor inhibitor (EGFR-TKI), a targeted therapy, has become a hotspot for treating NSCLC. Epidermal growth factor receptor (EGFR) is type I transmembrane tyrosine kinase receptor, a member of ErbB/HER family. Studies have found that EGFR inhibitors can enhance the radiosensitivity of cancer cells [9,10]

Methods

Discussion

Conclusion