2022 World Conference on Lung Cancer (ePosters)-EP08.05-004. The Optimal Intervention Timing of Hypofractionated Stereotactic Radiotherapy for EGFR Mutated NSCLC Patients With Limited Brain Metastases

EP08.05-004. The Optimal Intervention Timing of Hypofractionated Stereotactic Radiotherapy for EGFR Mutated NSCLC Patients With Limited Brain Metastases

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This study aimed to determine the optimal timing of hypofractionated stereotactic radiotherapy (HSRT) for non-small-cell lung cancer (NSCLC) patients with limited brain metastases (BMs) who also received tyrosine kinase inhibitors (TKIs). A retrospective analysis was conducted, and a total of 84 NSCLC patients with EGFR mutations and limited BMs were included. These patients received both TKIs and HSRT at different timings: upfront HSRT at the time of initial diagnosis of brain metastases, consolidative HSRT when there was no further decrease in intracranial lesion volume, or salvage HSRT in case of intracranial disease progression. The clinical efficacy and toxicities of the different intervention timings were evaluated. <br /><br />The results showed that upfront HSRT improved the intracranial progression-free survival (iPFS1) and overall progression-free survival (PFS1) compared to consolidative and salvage HSRT. It also reduced the initial intracranial failure rate. However, there were no significant differences in iPFS2 and PFS2 (starting from the initiation of TKI treatment) among the three groups. The incidence of cerebral radiation necrosis (CRN) was lowest in the consolidative HSRT group and highest in the upfront HSRT group, although the difference was not statistically significant. Poor prognostic factors for survival were hepatic metastases and Ds-GPA at 2-3.<br /><br />In conclusion, upfront HSRT improved the duration of intracranial response and reduced the initial intracranial failure rate in NSCLC patients with limited brain metastases who received TKIs. However, the timing of HSRT did not seem to affect the eventual therapeutic effect when TKIs and HSRT were both given. Further validation in prospective clinical studies is needed.

Asset Subtitle

Lin Zhou

Meta Tag

Speaker Lin Zhou

Topic Metastatic Non-small Cell Lung Cancer - Palliative Radiotherapy

Keywords

hypofractionated stereotactic radiotherapy

non-small-cell lung cancer

brain metastases

tyrosine kinase inhibitors

retrospective analysis

EGFR mutations

intracranial progression-free survival

overall progression-free survival

cerebral radiation necrosis

prognostic factors