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Local Therapy for Oligoprogressive Disease in Patients With Advanced Stage Non-small-cell Lung Cancer Harboring Epidermal Growth Factor Receptor Mutation

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机构: [1]State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [2]Sun Yat Sen Univ, Tungwah Hosp, Dept Radiat Oncol, Dongguan, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Dept Radiat Oncol, 651 Dongfengdong Rd, Guangzhou, Guangdong, Peoples R China; [4]Sun Yat Sen Univ, Canc Ctr, Dept Med Oncol, Guangzhou, Guangdong, Peoples R China; [5]Sun Yat Sen Univ, Canc Ctr, Dept Mol Diag & Radiol, Guangzhou, Guangdong, Peoples R China; [6]Sun Yat Sen Univ, Canc Ctr, Minimally Invas Intervent Div, Guangzhou, Guangdong, Peoples R China; [7]Sun Yat Sen Univ, Canc Ctr, Med Imaging Ctr, Guangzhou, Guangdong, Peoples R China
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关键词: Oligoprogression Progression-free survival Radiofrequency ablation Radiotherapy Tyrosine kinase inhibitors

摘要:
The effect of local therapy (LT) for oligoprogressive epidermal growth factor receptor (EGFR)-mutated nonesmall-cell lung cancer has not been well established. Forty-six patients with stage IIIB/IV EGFR-mutated nonesmall-cell lung cancer were treated by LT and continuing tyrosine kinase inhibitors for oligoprogression. The median overall and progression-free survival after LT were 13.0 and 7.0 months, respectively. EGFR mutation type, sites of LT, and time from first progressive disease to LT were prognostic of overall survival after LT. Introduction: The effect of local therapy (LT) for oligoprogressive epidermal growth factor receptor (EGFR)-mutated nonesmall-cell lung cancer (NSCLC) has not been well established. Forty-six patients with stage IIIB/IV EGFR-mutated NSCLC were treated by LT and continuing tyrosine kinase inhibitors (TKIs) for oligoprogression. The median overall survival (OS) and progression-free survival (PFS) after LT were 13.0 and 7.0 months, respectively. EGFR mutation type, sites of LT, and time from first progressive disease (PD) to LT were prognostic of OS after LT. Purpose: Patients with advanced stage EGFR-mutated NSCLC treated with EGFR TKIs could experience oligoprogression. This study investigated the benefits of LT and continuation of TKIs for oligoprogression retrospectively. Materials and Methods: Forty-six patients with stage IIIB/IV EGFR-mutated NSCLC on TKIs were treated by LT and continuation of TKIs for oligoprogressive disease. The impact of clinicopathologic variables on survival was explored using Cox regression. Results: With a median follow-up of 32 months, the 2-year OS was 65.2%, and the estimated OS was 35.0 months. The median OS after LT (LT-OS) was 13.0 months. The median PFS after LT (LT-PFS) was 7.0 months. Univariate analysis showed that stage at initial diagnosis, EGFR mutation type, site of LT, metastatic status at initial TKIs, and time from first PD to LT correlated with LT-OS significantly. Multivariate analysis suggested that EGFR mutation type (P = .001), sites of LT (P = .000), and time from first PD to LT (P = .034) were prognostic of LT-OS. Univariate analysis showed that metastatic status at initial TKIs and time from first PD to LT correlated with LT-PFS significantly. Multivariate analysis suggested that only time from first PD to LT (P = .000) was prognostic of LT-PFS. Conclusion: This study revealed that LTs are feasible and effective for EGFR-mutated NSCLC with oligoprogression. EGFR mutation type, sites of LT, and time from first PD to LT were prognostic factors for LT-OS. Time from first PD to LT was a prognostic factor for LT-PFS. (C) 2017 Elsevier Inc. All rights reserved.

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出版当年[2017]版:
大类 | 3 区 医学
小类 | 3 区 肿瘤学
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 肿瘤学
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第一作者机构: [1]State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Dept Radiat Oncol, 651 Dongfengdong Rd, Guangzhou, Guangdong, Peoples R China;
通讯作者:
通讯机构: [1]State Key Lab Oncol South China, Guangzhou, Guangdong, Peoples R China; [3]Sun Yat Sen Univ, Canc Ctr, Dept Radiat Oncol, 651 Dongfengdong Rd, Guangzhou, Guangdong, Peoples R China;
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