Timing of Stereotactic Body Radiotherapy in Advanced Non-Small Cell Lung Cancer with Epithelial Growth Factor Receptor Sensi-tive Mutations Following Epithelial Growth Factor Receptor-Tyro-sine Kinase Inhibitor Therapy
[Objective]To explore the timing of localized stereotactic body radiotherapy(SBRT)interven-tion following first generation epithelial growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI)ther-apy in advanced non-small cell lung cancer(NSCLC)with EGFR-sensitive mutations.[Methods]A prospective single arm phase Ⅱ clinical trial(ChiCTR-OIN-17013920)conducted at Taizhou Hospital Affiliated to Wenzhou Medical University from September 2016 to November 2022 was evaluated.In the trial,47 NSCLC patients with EGFR-sensitive mutations received first generation EGFR-TKI,and un-derwent primary lesion SBRT one month after TKI therepy starting(early SBRT group);and 27 matched patients received EGFR-TKI,and underwent SBRT after primary tumor progression(late SBRT group).The progression-free survival(PFS),overall survival(OS),adverse event(AE),and T790M mutation rate after drug resistance were compared between two groups.[Results]There were no significant differ-ences in age,sex,smoking history,ECOG score,EGFR mutation type,TNM staging,number and site of metastasis between two groups(all P＞0.05).There was no significant difference in median PFS(15.23 months vs 10.20 months,P=0.13),the total median PFS(15.23 months vs 18.20 months,P=0.54),and the median OS(27.90 months vs 36.61 months,P=0.54)between the early SBRT group and the late SBRT group.There was no grade 3 or above AE observed in either group,and there was no significant difference in the incidence of grade 2 or below AE.The incidence of T790M mutation after drug resistance progression was 58.5％(24/41)in the early SBRT group and 33.3％(9/27)in the late SBRT group(P=0.05).[Conclusion]There is no significant difference in survival and AE of EGFR-sensitive mutant NSCLC patients receiving early SBRT or late SBRT following first-generation EGFR-TKI therapy.After drug resistance,the T790M mutation rate in patients with early SBRT is higher than that with late SBRT,which need to be further studied.
NETL
NSTL
万方数据
