Analysis Of Prognostic Factors Of Osimertinib Mesylate In The Treatment Of Brain Metastases From EGFR Gene Mutant Non-small Cell Lung Cancer

Purpose:To investigate the clinical efficacy and prognostic factors of osimertinib mesylate in the treatment of brain metastases from epidermal growth factor receptor(EGFR)mutant lung cancer(NSCLC).Methods: The data of 60 patients with lung adenocarcinoma who were admitted to the Department of Radiation Oncology of the First Affiliated Hospital of Bengbu Medical College from May 2017-December 2019,were diagnosed with brain metastases,and received first-line treatment with osimertinib mesylate were retrospectively analyzed.Kaplan-Meier variable was used for survival analysis,survival curve was drawn and survival rate was calculated.Log-rank method was used for univariate analysis.Cox risk regression model was used for multivariate analysis.The survival status and influencing factors of NSCLC patients with brain metastases treated with osimertinib Mesylate were investigated.Results: Thirty-eight of the 60 patients died;the overall survival(OS)was up to 17.0months,and the intracranial progression-free survival(IPFS)was 11.0 months;the results of univariate analysis showed that KPS score(P < 0.01),presence or absence of brain symptoms(P < 0.01),number of brain metastases(P = 0.03),and presence or absence of liver metastases(P < 0.01)were the influencing factors of IPFS and overall survival(P <0.05)after treatment with osimertinib mesylate.Multivariate Cox proportional hazards regression model further showed that KPS score and liver metastasis were independent prognostic factors for IPFS(P = 0.021 and P = 0.035)and OS(P = 0.003 and P = 0.004)in NSCLC patients with brain metastases;in addition,the presence or absence of brain symptoms was also an independent prognostic factor for IPFS(P = 0.036).Conclusion:Osimertinib mesylate is effective in the treatment of NSCLC patients with brain metastases;KPS score ≤ 70 and poor prognosis of patients with liver metastases can be used as an independent indicator to predict the efficacy.In addition,IPFS was significantly longer in patients with asymptomatic brains than in symptomatic patients,but there was no significant advantage for OS.