A Analysis Observation Of Concomitant Therapy Of Molecular Targeted Therapy And Whole Brain Radiotherapy In Patients Of NSCLC Combined With Brain Metastases

Objective and Background:Brain metastases from non-small cell lung cancer (NSCLC) alwys with higherincidence and poor prognosis,Radiotherapy is the most common treatment for brainmetastases. Recent studies have revealed that Targeted-therapy have made someadvance for the treatment of NSCLC.The aim of this study was to evaluates the Theclinical value in the treatment which use both of Radiotherapy and EGFR-TKI forbrain metastases from NSCLC.Patients and Methods:We retrospectively reviewed43NSCLC patients with brain metastases.,in whichcontains38patients of radiotherapy combined with EGFR-TKI treatment and5patients of simple EGFR-TKI treatment.Radiotherapy using the methods that linearaccelerator of6MV X-ray three-dimensional conformal Synchronization or has theline of whole brain irradiation and Increase the dose of region focus, Whole brainirradiation dose DT30Gy-40Gy, increase the dose of region focus DT14Gy-20Gy。Conventional fractionated,5times a week.EGFR-TKI treatment with oral gefitiniberlotinib250mg/d or erlotinib150mg/d until disease progression、death、occursintolerable adverse reactions。 Observed short-term effect and survival， madeunivariate analysis of prognostic factors and perform Multivariate analysis throughCox’s proportion risk model.Survival analysis was compared with Kaplan-Meiermethod and Log-rank test respectively, meanwhile,depicts the survival curve.Allstatistical results of P <0.05was considered statistically significant.Results:Our study contains43patients,for intracranial lesions, complete response (CR)was observed in2patients, partial response (PR) in28patients, stable disease (SD) in10patients, and progressive disease in3patients, with an objective response rate(ORR)of69.8%（30/43）and a disease control rate (DCR) of93.0%（40/43）. Thenumber of extracranial lesions was41,3cases of which were during the course oftreatment. CR in0patient,PR in11patients, SD in24patients,and progressive disease in6patients,with an ORR of26.8%（11/41）and a DCR of85.4%（35/41）.Themedian progression-free survival and median survival time were9.0months(95%CI)and17months, respectively(95%CI).Respectively, The multivariate analysisshowed that the patients’ PS score, the number of extracranial diseases and histologywere related progression-free survival (P=0.001, P=0.021,P=0.041). Both thepatients’ PS score and the number of extracranial diseases were two independentprognostic factors in the multivariate analysis (P=0.000,P=0.021).5Patients withbrain metastases through simple EGFR-TKI treatment, PR in1patient lasts6months,SD in2patients lasts4months,PD in1patient after2months.Conclusion:The epidermal growth factor receptor tyrosine kinase inhibitors is active forbrain metastases from NSCLC. This indicates that it can become a treatmen optionfor brain metastases of NSCLC.The favorable prognostic and general condition arerelated with the condition of Extracranial lesions control.