Radiotherapy combined with tyrosine kinase inhibitors in non-small cell lung cancer with brain metastasis driven by epidermal growth factor receptor mutations

Abstract

Objective To evaluate the clinical value and safety of radiotherapy combined with tyrosine kinase inhibitors (TKI) in non-small cell lung cancer (NSCLC) with brain metastasis driven by epidermal growth factor receptor (EGFR) mutation. Methods A retrospective cohort of 21 non-small cell lung cancer (NSCLC) patients with EGFR mutation-driven brain metastasis was recruited. 10 patients (treatment group) were randomly selected for radiotherapy combined with TKI treatment, and 11 patients (control group) were treated with radiotherapy. Tumor size was measured and clinical efficacy was evaluated by MRI in the four weeks after radiotherapy. Since then, a clinical response was evaluated every three months until disease progression, and the median overall survival time was calculated. Results The objective remission was 8 cases in treatment group and 4 cases in control group. The disease control was 9 cases in treatment group and 8 cases in control group. The median overall survival time of treatment and control groups was 11.2 months and 6.4 months, respectively. Adverse reactions in treatment group mainly contained nausea, diarrhea and rash, which all were tolerated. Conclusion Radiotherapy combined with TKI is superior to radiotherapy alone in effect and safety for treatment of NSCLC with EGFR mutation-driven brain metastasis. Key words: Radiotherapy; Tyrosine kinase inhibitors; Epidermal growth factor receptor driven mutation; Cancer, non-small cell lung; Brain metastasis