Background: A survival analysis and the influencing factors for non-small cell lung cancer (NSCLC) patients with brain metastases accepting first-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKIs) treatment have not yet been elucidated to date. In this study, we collected and analyzed the survival data of NSCLC patients with brain metastasis to obtain evidence and to provide guidance in clinical practice.
Methods: NSCLC patients with brain metastases who were treated with first-generation EGFR-TKIs were retrospectively collected in 2012-2013 from Shanghai Chest Hospital, Shanghai Jiao Tong University. The Kaplan-Meier method and Cox regression were performed for univariate and multivariate analyses, respectively, to explore the independent predictors influencing the survival of patients with NSCLC brain metastases.
Results: The median progression-free survival (PFS) and median overall survival (OS) of all patients treated with first-generation EGFR-TKIs were 10.0 months (95%CI: 8.3-11.7) and 28.0 months (95%CI: 22.9-33.1), respectively. Pathological subtypes were the independent predictors of PFS (P=0.001), and tumor differentiations were the independent predictors of OS (P=0.050).
Conclusions: First-generation EGFR-TKIs showed promising efficacy in NSCLC patients with brain metastases. PFS was longer in patients with adenocarcinoma than in those with a non-adenocarcinoma subtype. OS was longer in patients with differentiated tumors than in those who developed poorly differentiated tumors. .
背景与目的 非小细胞肺癌（non-small cell lung cancer, NSCLC）脑转移患者接受一代表皮生长因子受体酪氨酸激酶抑制剂（epidermal growth factor receptor-tyrosine kinase inhibitors, EGFR-TKIs）的生存数据及影响因素未完全阐明。本研究对存在脑转移的NSCLC患者的生存数据进行分析，以期为指导临床实践提供一定的研究证据。方法 回顾性收集上海交通大学附属胸科医院2012年-2013年确诊肺癌脑转移并接受一代EGFR-TKIs治疗的病例。采用Kaplan-Meier单因素、Cox多因素分析方法，探讨NSCLC脑转移患者接受EGFR-TKIs的生存情况及影响因素。结果 总体人群中位无进展生存时间（progression-free survival, PFS）为10.0个月（95%CI: 8.3-11.7），中位生存时间（overall survival, OS）为28.0个月（95%CI: 22.9-33.1）。病理组织类型、肿瘤分化程度分别是患者接受EGFR-TKIs后PFS、OS的独立影响因素（P分别为0.001、0.050）。结论 NSCLC脑转移患者接受一代EGFR-TKIs具有良好的疗效，腺癌亚型患者的PFS长于非腺癌患者，其他肿瘤分化程度患者的OS长于肿瘤低分化患者。.