Epidermal Growth Factor Receptor Mutation Status Confers Survival Benefit in Patients with Non-Small-Cell Lung Cancer Undergoing Surgical Resection of Brain Metastases: A Retrospective Cohort Study.
Epidermal Growth Factor Receptor Mutation Status Confers Survival Benefit in Patients with Non-Small-Cell Lung Cancer Undergoing Surgical Resection of Brain Metastases: A Retrospective Cohort Study.
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表皮生长因子受体突变状态为接受脑转移手术切除的非小细胞肺癌患者带来生存获益：一项回顾性队列研究。
DOI：
10.1016/j.wneu.2019.01.112
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发表时间：
2019
影响因子：
2
通讯作者：
HaydenGephart,Melanie
中科院分区：
文献类型：
--
作者：
Huang,Yuhao;Chow,KevinKH;Aredo,JacquelineV;Padda,SukhmaniK;Han,SummerS;Kakusa,BinaW;HaydenGephart,Melanie
背景对于接受神经外科手术切除的有症状脑转移瘤的非小细胞肺癌（NSCLC）患者，几乎没有可用的预后标志物。（EGFR，KRAS，ALK，ROS1，和BRAF）方法我们回顾了104例非小细胞肺癌患者的电子健康记录，这些患者接受了神经外科切除术，2000年1月至2018年1月期间在学术机构发生脑转移。我们使用多变量考克斯比例风险回归模型，以评估神经外科手术后的总生存率（OS）和临床病理因素，包括突变status.ResultsMean年龄在这项研究中的患者为61（±12）岁，44%是男性之间的关联。神经外科手术后的中位OS为24个月（95%置信区间，18-34个月）。我们的多变量分析显示，肿瘤中EGFR突变的存在与OS改善显著相关（风险比[HR]，0.214;P= 0.029），与酪氨酸激酶抑制剂的使用无关。KRAS、ALK、ROS 1和BRAF突变与生存率无关（均P> 0.05）。相反，老年人（HR，1.039;P= 0.029），多次脑放射手术史（HR，9.197;P< 0.001），和颅外转移的存在（HR，2.556; P= 0.016）导致死亡风险增加。突变的非小细胞肺癌脑转移患者与无此突变的患者相比，生存率提高，与酪氨酸激酶抑制剂的使用无关。生存率降低与年龄较大、既往多次脑放疗和颅外转移有关。
BackgroundFew prognostic markers are available for patients with non-small-cell lung cancer (NSCLC) undergoing neurosurgical resection of symptomatic brain metastases.ObjectiveWe investigated whether tumor mutation status (EGFR,KRAS,ALK, ROS1,andBRAF) and treatment history were associated with survival after neurosurgery.MethodsWe reviewed the electronic health records of 104 patients with NSCLC with genomic profiling who underwent neurosurgical resection for symptomatic brain metastases at an academic institution between January 2000 and January 2018. We used multivariate Cox proportional hazards regression models to evaluate the association between overall survival (OS) after neurosurgery and clinicopathologic factors, including mutation status.ResultsMean age of patients in this study was 61 (±12) years, and 44% were men. The median OS after neurosurgery was 24 months (95% confidence interval, 18–34 months). Our multivariate analysis showed that the presence of anEGFRmutation in the tumor was significantly associated with improved OS (hazard ratio [HR], 0.214;P= 0.029), independent of tyrosine kinase inhibitor use. Presence ofKRAS,ALK,ROS1, andBRAFalterations was not associated with survival (allP> 0.05). Conversely, older age (HR, 1.039;P= 0.029), a history of multiple brain irradiation procedures (HR, 9.197;P< 0.001), and presence of extracranial metastasis (HR, 2.556;P= 0.016) resulted in increased risk of mortality.ConclusionsPatients requiring surgical resection of an epidermal growth factor receptor–mutated NSCLC brain metastasis had an associated improved survival compared with patients without this mutation, independent of tyrosine kinase inhibitor use. Decreased survival was associated with older age, multiple previous brain radiation therapies, and extracranial metastasis.
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影响因子：
51.1
作者：
Mitsudomi, Tetsuya;Morita, Satoshi;Fukuoka, Masahiro
通讯作者：
Fukuoka, Masahiro
影响因子：
158.5
作者：
Peters, Solange;Camidge, D. Ross;Mok, Tony
通讯作者：
Mok, Tony
基因改变和酪氨酸激酶抑制对肺腺癌和脑转移患者的存活和死亡原因的影响。
DOI：
10.1016/j.ijrobp.2016.06.006
发表时间：
2016-10-01
期刊：
International journal of radiation oncology, biology, physics
影响因子：
--
作者：
Sperduto PW;Yang TJ;Beal K;Pan H;Brown PD;Bangdiwala A;Shanley R;Yeh N;Gaspar LE;Braunstein S;Sneed P;Boyle J;Kirkpatrick JP;Mak KS;Shih HA;Engelman A;Roberge D;Arvold ND;Alexander B;Awad MM;Contessa J;Chiang V;Hardie J;Ma D;Lou E;Sperduto W;Mehta MP
通讯作者：
Mehta MP
影响因子：
6
作者：
Billing, PS;Miller, DL;Pairolero, PC
通讯作者：
Pairolero, PC
影响因子：
4.1
作者：
Karlsson, Bengt;Hanssens, Patrick;Beute, Guus
通讯作者：
Beute, Guus