Risk of brain metastasis reduced after erlotinib treatment in advanced pulmonary adenocarcinoma patients with sensitive EGFR mutation.
Risk of brain metastasis reduced after erlotinib treatment in advanced pulmonary adenocarcinoma patients with sensitive EGFR mutation.
复制标题
EGFR 敏感突变的晚期肺腺癌患者接受厄洛替尼治疗后脑转移风险降低。
DOI：
10.2147/ott.s100105
复制
发表时间：
2016
影响因子：
4
通讯作者：
Yu J
中科院分区：
文献类型：
--
作者：
Liu J;Xing L;Meng X;Yue J;Meng X;Xie P;Li X;Kong L;Yu J
脑转移（BM）与生活质量受损和死亡率增加有关。该研究旨在比较携带表皮生长因子受体（EGFR）突变的IIIB/IV期肺腺癌患者服用厄洛替尼和化疗后发生脑转移的风险。符合条件的患者进行匹配因素配对过程，匹配因素包括年龄、性别、表现状态评分、一线或二线治疗、一线化疗方案（二线治疗亚组）、IIIB期或IV期、EGFR突变基因型。记录并比较两组患者的BM和死亡风险。共纳入129对配对样本进行分析。在21.5个月的中位随访期间，接受厄洛替尼治疗的患者发生脑转移风险的时间更长，2年内脑转移的发生率低于化疗患者，一线治疗、二线治疗、IIIB期、IV期、19外显子缺失突变和21外显子L858R突变亚组也是如此。两组或任何亚组的总生存时间和2年生存率相似。多因素分析显示，接受厄洛替尼治疗的患者（风险比为1.695，P=0.001）和IIIB期患者（风险比为1.751，P=0.001）脑迁移迟缓。厄洛替尼可降低携带敏感EGFR突变的晚期肺腺癌患者的脑转移风险。
Brain metastasis (BM) is associated with impaired quality of life and increased mortality. The study aimed to compare BM risk after erlotinib administration and chemotherapy in stage IIIB/IV pulmonary adenocarcinoma patients harboring epidermal growth factor receptor (EGFR) mutation. Eligible patients underwent match pair process with matching factors, including age, sex, performance status score, first-line or second-line treatment, first-line chemotherapy regimen (for the second-line treatment subgroup), stage IIIB or IV, and genotypes of EGFR mutation. BM and mortality risk of both groups were recorded and compared. In total 129 matched pairs were included for analysis. During a median follow-up of 21.5 months, time to BM risk was longer and incidences of BM within 2 years were lower in patients who received erlotinib than chemotherapy in total population, as well as subgroups of first-line treatment, second-line treatment, stage IIIB, stage IV, exon 19 deletion mutation, and exon 21 L858R mutation. Similar overall survival time and 2-year survival rates were seen in two groups totally or in any subgroup. Multivariate analysis showed that BM was retarded in patients who received erlotinib administration (hazard ratio, 1.695; P=0.001) and in patients who were in stage IIIB (hazard ratio, 1.751; P=0.001). Erlotinib administration decreases BM risk in advanced pulmonary adenocarcinoma patients harboring sensitive EGFR mutations.