Journal
CLINICAL LUNG CANCER
Volume 18, Issue 6, Pages E369-E373Publisher
CIG MEDIA GROUP, LP
DOI: 10.1016/j.cllc.2017.04.002
Keywords
Oligoprogression; Progression-free survival; Radiofrequency ablation; Radiotherapy; Tyrosine kinase inhibitors
Categories
Funding
- Science and Technology Planning Project of Guangdong Province, China [2016A020215190, 2016ZC0030]
- Scientific Research Foundation for the Returned Overseas Chinese Scholars
- State Education Ministry
- National Nature Science Fund [81301932]
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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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