Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study
Abstract Background and purpose Leptomeningeal metastasis (LM) is a rare but detrimental complication in patients with non-small cell lung cancer (NSCLC). Although whole brain radiotherapy (WBRT) is used to eliminating cancer cells or microscopic foci, it is becoming less favorable due to the concer...
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doaj-cab652a4a0a246ee97b332de743de8592020-11-25T03:24:24ZengBMCRadiation Oncology1748-717X2020-07-011511810.1186/s13014-020-01627-yWhole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective studyJunjie Zhen0Lei Wen1Mingyao Lai2Zhaoming Zhou3Changguo Shan4Shaoqun Li5Tao Lin6Jie Wu7Wensheng Wang8Shaoqiang Xu9Da Liu10Ming Lu11Dan Zhu12Longhua Chen13Linbo Cai14Cheng Zhou15Department of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityDepartment of Oncology, Guangdong Sanjiu Brain HospitalDepartment of Oncology, Guangdong Sanjiu Brain HospitalDepartment of Oncology, Guangdong Sanjiu Brain HospitalDepartment of Oncology, Guangdong Sanjiu Brain HospitalDepartment of Oncology, Guangdong Sanjiu Brain HospitalDepartment of Neurosurgery, Guangdong Sanjiu Brain HospitalDepartment of Neurosurgery, Guangdong Sanjiu Brain HospitalDepartment of Radiology, Guangdong Sanjiu Brain HospitalDepartment of Laboratory Medicine, Guangdong Sanjiu Brain HospitalDepartment of Neurosurgery, Guangdong Sanjiu Brain HospitalDepartment of Neurosurgery, Guangdong Sanjiu Brain HospitalDepartment of Neurosurgery, Guangdong Sanjiu Brain HospitalDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityDepartment of Oncology, Guangdong Sanjiu Brain HospitalDepartment of Radiation Oncology, Nanfang Hospital, Southern Medical UniversityAbstract Background and purpose Leptomeningeal metastasis (LM) is a rare but detrimental complication in patients with non-small cell lung cancer (NSCLC). Although whole brain radiotherapy (WBRT) is used to eliminating cancer cells or microscopic foci, it is becoming less favorable due to the concerns over neurocognitive toxicity. This study aimed to re-evaluate the role of WBRT in the setting of modern targeted therapy. Materials and methods From December 2014 to March 2019, 80 NSCLC patients with cytologically and/or radiologically proven LM diagnosis were retrospectively analyzed. Results The median OS (mOS) after diagnosis of LM was 8.0 (95%CI: 4.4 to 11.6) months, and the one-year OS was 39.4%. The mOS for EGFR-mutated LM patients was 12.6 (3.0 to 22.2) months versus only 4.1 (2.8 to 5.4) for patients with wild-type EGFR (P < 0.001). Younger patients (< 53.5 yrs.) appeared to have a better OS than older patients (≥53.5 yrs.) (12.6 vs. 6.1, P = 0.041). No survival benefits were found in EGFR-mutated patients who received WBRT (P = 0.490). In contrast, mOS was significantly prolonged in wild-type EGFR patients with WBRT versus non-WBRT (mOS: 8.0 vs. 2.1, P = 0.002). Multivariate analysis indicated that WBRT (P = 0.025) and younger age (P = 0.048) were independent prognostic factors that predicted prolonged survival for wild-type EGFR LM patients from NSCLC. Conclusion Our study demonstrated that WBRT has clear survival advantages for patients with wild-type EGFR, and molecular biological stratification of LM patients for WBRT is highly recommended.http://link.springer.com/article/10.1186/s13014-020-01627-yLeptomeningeal metastasisWhole brain radiotherapy (WBRT)Non-small cell lung cancer (NSCLC)EGFR mutationPrognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Junjie Zhen Lei Wen Mingyao Lai Zhaoming Zhou Changguo Shan Shaoqun Li Tao Lin Jie Wu Wensheng Wang Shaoqiang Xu Da Liu Ming Lu Dan Zhu Longhua Chen Linbo Cai Cheng Zhou |
spellingShingle |
Junjie Zhen Lei Wen Mingyao Lai Zhaoming Zhou Changguo Shan Shaoqun Li Tao Lin Jie Wu Wensheng Wang Shaoqiang Xu Da Liu Ming Lu Dan Zhu Longhua Chen Linbo Cai Cheng Zhou Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study Radiation Oncology Leptomeningeal metastasis Whole brain radiotherapy (WBRT) Non-small cell lung cancer (NSCLC) EGFR mutation Prognosis |
author_facet |
Junjie Zhen Lei Wen Mingyao Lai Zhaoming Zhou Changguo Shan Shaoqun Li Tao Lin Jie Wu Wensheng Wang Shaoqiang Xu Da Liu Ming Lu Dan Zhu Longhua Chen Linbo Cai Cheng Zhou |
author_sort |
Junjie Zhen |
title |
Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study |
title_short |
Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study |
title_full |
Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study |
title_fullStr |
Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study |
title_full_unstemmed |
Whole brain radiotherapy (WBRT) for leptomeningeal metastasis from NSCLC in the era of targeted therapy: a retrospective study |
title_sort |
whole brain radiotherapy (wbrt) for leptomeningeal metastasis from nsclc in the era of targeted therapy: a retrospective study |
publisher |
BMC |
series |
Radiation Oncology |
issn |
1748-717X |
publishDate |
2020-07-01 |
description |
Abstract Background and purpose Leptomeningeal metastasis (LM) is a rare but detrimental complication in patients with non-small cell lung cancer (NSCLC). Although whole brain radiotherapy (WBRT) is used to eliminating cancer cells or microscopic foci, it is becoming less favorable due to the concerns over neurocognitive toxicity. This study aimed to re-evaluate the role of WBRT in the setting of modern targeted therapy. Materials and methods From December 2014 to March 2019, 80 NSCLC patients with cytologically and/or radiologically proven LM diagnosis were retrospectively analyzed. Results The median OS (mOS) after diagnosis of LM was 8.0 (95%CI: 4.4 to 11.6) months, and the one-year OS was 39.4%. The mOS for EGFR-mutated LM patients was 12.6 (3.0 to 22.2) months versus only 4.1 (2.8 to 5.4) for patients with wild-type EGFR (P < 0.001). Younger patients (< 53.5 yrs.) appeared to have a better OS than older patients (≥53.5 yrs.) (12.6 vs. 6.1, P = 0.041). No survival benefits were found in EGFR-mutated patients who received WBRT (P = 0.490). In contrast, mOS was significantly prolonged in wild-type EGFR patients with WBRT versus non-WBRT (mOS: 8.0 vs. 2.1, P = 0.002). Multivariate analysis indicated that WBRT (P = 0.025) and younger age (P = 0.048) were independent prognostic factors that predicted prolonged survival for wild-type EGFR LM patients from NSCLC. Conclusion Our study demonstrated that WBRT has clear survival advantages for patients with wild-type EGFR, and molecular biological stratification of LM patients for WBRT is highly recommended. |
topic |
Leptomeningeal metastasis Whole brain radiotherapy (WBRT) Non-small cell lung cancer (NSCLC) EGFR mutation Prognosis |
url |
http://link.springer.com/article/10.1186/s13014-020-01627-y |
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