The impact of EGFR mutations on the incidence and survival of stages I to III NSCLC patients with subsequent brain metastasis.
The impact of EGFR mutations on the incidence and survival of stages I to III NSCLC patients with subsequent brain metastasis.
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DOI：
10.1371/journal.pone.0192161
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Su WC
中科院分区：
文献类型：
--
作者：
Chang WY;Wu YL;Su PL;Yang SC;Lin CC;Su WC
既往研究已证实EGFR突变与远处转移相关。然而，I-III期非小细胞肺癌（NSCLC）患者中随后脑转移（BM）的相关性仍不确定。我们进行了一项回顾性分析，以阐明EGFR突变对I-III期NSCLC患者BM发生率和相关生存期的影响。共491例接受EGFR突变筛查的患者回顾性入组。使用脑部MRI或CT来检测BM。采用Kaplan-Meier法估计随后BM的累积发生率和BM诊断后的总生存期（OS），并采用对数秩检验进行比较。我们进行了考克斯比例风险回归，以预测随后的BM和BM后OS的决定因素。携带EGFR突变的患者BM的累积发生率似乎高于未携带EGFR突变的患者，但未达到统计学显著性（风险比[HR] = 1.75，95%置信区间[CI] = 0.73~1.81）。在调整可能的混杂因素（包括年龄、吸烟、分期和肿瘤大小）后，EGFR突变成为随后BM的预测因子之一（HR = 1.89，95%CI = 1.12~3.17，p = 0.017）。尽管EGFR突变患者和野生型EGFR患者BM后的生存率没有统计学差异，（中位生存期：17.8 vs. 12.2个月，HR = 0.79，95% CI = 0.45-1.40），EGFR 19缺失（Del）患者BM后的生存期往往长于非EGFR 19 Del组（中位生存期：29.4 vs. 14.3个月，HR 0.58，95% CI = 0.32-1.09，p = 0.089）。总之，我们的数据表明EGFR突变是I-III期患者随后BM的预测因子之一。由于样本量小，需要更多的研究来证实我们的结果。
Previous studies have demonstrated the association between EGFR mutations and distant metastasis. However, the association for subsequent brain metastasis (BM) in stages I-III non-small cell lung cancer (NSCLC) patients remains inconclusive. We conducted a retrospective analysis to clarify the impact of EGFR mutations on the incidence of BM and associated survival in patients with stage I-III NSCLC. A total of 491 patients screened for EGFR mutations were retrospectively enrolled. Brain MRI or CT was used to detect the BM. Cumulative incidence of subsequent BM and overall survival (OS) after diagnosis of BM were estimated by the Kaplan-Meier method and compared using log-rank test. We performed Cox proportional hazard regression for predictors of subsequent BM and determinants of OS after BM. The cumulative incidence of BM seemed higher in patients harboring EGFR mutations than those without EGFR mutations although it did not reach statistical significance (hazard ratio [HR] = 1.75, 95% confidence interval [CI] = 0.73~1.81). After adjusting possible confounders, including age, smoking, stage, and tumor size, EGFR mutation became one of the predictors for subsequent BM (HR = 1.89, 95% CI = 1.12~3.17, p = 0.017). Though there was no statistical difference in survival after BM between patients with EGFR mutations and wild-type EGFR (median survival: 17.8 vs. 12.2 months, HR = 0.79, 95% CI = 0.45–1.40), patients with EGFR 19 deletion (Del) tended to have a longer survival after BM than the non-EGFR 19 Del group (median survival: 29.4 vs. 14.3 months, HR 0.58, 95% CI = 0.32–1.09, p = 0.089). In conclusion, our data suggested EGFR mutation to be one of the predictors for subsequent BM in stage I-III patients. Given the small sample size, more studies are warranted to corroborate our results.
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影响因子：
5.3
作者：
Baldwin, BR;Timchenko, NA;Zahnow, CA
通讯作者：
Zahnow, CA
影响因子：
--
作者：
Hsu CH;Tseng CH;Chiang CJ;Hsu KH;Tseng JS;Chen KC;Wang CL;Chen CY;Yen SH;Chiu CH;Huang MS;Yu CJ;Tsai YH;Chen JS;Tsai CM;Chou TY;Lin KC;Tsai MH;Lee WC;Ku HY;Liu TW;Yang TY;Chang GC
通讯作者：
Chang GC
影响因子：
15.9
作者：
Gao, Sizhi Paul;Mark, Kevin G.;Bromberg, Jacqueline F.
通讯作者：
Bromberg, Jacqueline F.
影响因子：
3.1
作者：
Enomoto, Yasunori;Takada, Kazuto;Kojima, Eiji
通讯作者：
Kojima, Eiji
DOI：
10.3904/kjim.2015.158
发表时间：
2018-01
期刊：
The Korean journal of internal medicine
影响因子：
--
作者：
Baek MY;Ahn HK;Park KR;Park HS;Kang SM;Park I;Kim YS;Hong J;Sym SJ;Park J;Lee JH;Shin DB;Cho EK
通讯作者：
Cho EK