Curative effects of icotinib combined with radiotherapy in non-small cell lung cancer with brain metastasis

Abstract

Objective To study the clinical efficacy and safety of icotinib hydrochloride tablets combined with whole brain radiotherapy (WBRT) in non-small cell lung cancer (NSCLC) brain metastasis. Methods Fifty-three patients with NSCLC brain metastasis who were unable to tolerate chemotherapy or che-motherapy failed were selected in Baotou Central Hospital from October 2010 to April 2015. The patients were divided into the observation group (n=27) and the control group (n=26) using random number table method. Two patients were dropped out, one in the control group and one in the observation group. The patients in the control group were given WBRT (30 Gy/15 Fx). On this basis, the patients in the observation group were given icotinib hydrochloride tablets 125 mg, 3 times a day. The patients were followed up for 18 months after the end of WBRT. The adverse reactions, clinical efficacy and the median survival times of the two groups were compared. Results The objective response rate of the observation group was 88.5%, which was higher than that of the control group (64.0%), and the difference was statistically significant (χ2=4.238, P=0.040). The incidence rates of skin rash and liver function damage in the observation group were 76.9% and 15.4%, which were higher than those in the control group (0, χ2=31.638, P<0.001; χ2=4.173, P=0.041). However, most of them were degree Ⅰ-Ⅱ, and they were tolerable. There were no significant differences in the incidence of myelosuppression and gastrointestinal reactions between the two groups (26.9% vs. 20.0%, χ2=0.339, P=0.560; 34.6% vs. 28.0%, χ2=0.259, P=0.611). The median survival time in the observation group (9.0 months) was longer than that in the control group (7.0 months). The one year survival rate of the observation group was 33.3%, which was higher than that of the control group (23.1%), but the difference was not significant (χ2=0.676, P=0.411). Conclusion Icotinib hydrochloride tablets combined with WBRT in the treatment of brain metastasis with NSCLC can significantly improve the curative effects of brain metastasis, and it has a survival advantage, with tolerable adverse reactions. Key words: Radiotherapy; Carcinoma, non-small-cell lung; Icotinib; Brain metastasis