Abstract
Objective: This study aimed to investigate the relationship between the timing of stereotactic radiosurgery (SRS) intervention and the complications of cerebral radiation necrosis (CRN) in patients with brain metastases of lung adenocarcinoma who received tyrosine kinase inhibitor (TKI) treatment.Methods: A total of 361 targets from 257 patients with brain oligometastases of lung adenocarcinoma who received CyberKnife treatment between 2010 and 2017 were retrospectively collected from three CyberKnife centers. The difference in brain necrosis between patients with or without TKI application was statistically counted. Logistic regression analysis was used to analyze the effect of applying TKI on the occurrence of CRN in patients and the effect of SRS before and after TKI resistance on CRN.Results: The rate of CRN in the TKI group was significantly higher than that in the non-TKI group. The incidence of brain necrosis in patients undergoing SRS after drug resistance was significantly higher than that in patients undergoing SRS before drug resistance. Regression analysis showed that combination of TKI with SRS, and SRS after TKI resistance were important influencing factors for CRN.Conclusion: Performing the SRS for brain metastases after TKI resistance worsened the occurrence of CRN of patients treated with TKI.Clinical Trial Registration: Chinese clinical trial registry, http://www.chictr.org.cn/edit.aspx?pid=38395&htm=4, Registration number: ChiCTR1900022750.
Highlights
Whether radiotherapy or targeted therapy should be performed first for brain metastases of non-small-cell lung cancer (NSCLC) has remained controversial
This study aimed to investigate the relationship between the timing of stereotactic radiosurgery (SRS) intervention and the complications of cerebral radiation necrosis (CRN) in patients with brain metastases of lung adenocarcinoma who received tyrosine kinase inhibitor (TKI) treatment
Performing the SRS for brain metastases after TKI resistance worsened the occurrence of CRN of patients treated with TKI
Summary
Whether radiotherapy or targeted therapy should be performed first for brain metastases of non-small-cell lung cancer (NSCLC) has remained controversial. There were no reports concerning the increased occurrence of radiotherapy complications such as cerebral radiation necrosis (CRN), which further affected the quality of life in patients receiving stereotactic radiosurgery (SRS) after tyrosine kinase inhibitor (TKI) resistance. This study retrospectively analyzed the real-world case data on whether the TKI was applied when performing SRS, as well as the occurrence of CRN when performing SRS before and after TKI resistance, in patients with brain metastases of NSCLC from multiple centers. We investigated the TKI medication combined with SRS, and the occurrence of CRN and its impact on cognitive function and quality of life when performing SRS before and after drug resistance. This study was expected to provide evidence and reference for the treatment of such patients in clinical practice
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
