Role of Recursive Partitioning Analysis and Graded Prognostic Assessment on Identifying Non-Small Cell Lung Cancer Patients with Brain Metastases Who May Benefit from Postradiation Systemic Therapy

作     者：Shuai Liu Peng Chen Yan-Wei Liu Xue-Nan GU Xiao-Guang Qiu Bo Li Liu Shuai;Chen Peng;Liu Yan-Wei;Gu Xue-Nan;Qiu Xiao-Guang;Li Bo

作者机构：Department of Radiation Oncology BeijLng Tiantan Hospital Capital Medical University Beijing 100050 China Department of Thoracic Oncology Tianjin Medical University Cancer Institute and Hospital Tianjin 300060 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2018年第131卷第10期

页      面：1206-1213页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Chemotherapy Non-Small Cell Lung Cancer Recursive Partitioning Analysis Stereotactic Radiosurgery Tyrosine Kinase Inhibitors Whole-Brain Radiation Therapy 

摘      要：Background：The role ofpostradiation systemic therapy in non-small cell lung cancer （NSCLC） patients with brain metastasis （BM） was ***,we explored the role of Radiation Therapy Oncology Group recursive partitioning analysis （RTOG-RPA） and graded prognostic assessment （GPA） in identifying population who may benefit from postradiation systemic ***：The clinical data of NSCLC patients with documented BM from August 2007 to April 2015 of two hospitals were studied *** regression was used for multivariate *** of patients with or without postradiation systemic therapy was compared in subgroups stratified according to RTOG-RPA or ***：Of 216 included patients,67.1% received stereotactic radiosurgery （SRS）,24.1% received whole-brain radiation therapy （WBRT）,and 8.8% received *** radiotherapy,systemic therapy was administered in 58.3% of *** analysis found that postradiation systemic therapy （yes ***） （hazard ratio [HR] =0.36 l,95% confidence interval [CI] =0.202-0.648,P =0.001）,radiation technique （SRS ***） （HR =0.462,95% CI =0.238-0.849,P =0.022）,extracranial metastasis （yes ***） （HR =3.970,95% CI =1.757-8.970,P =0.001）,and Kamofsky performance status （〈70 vs.≥70） （HR =5.338,95% CI =2.829-10.072,P 〈 0.001） were independent factors for *** analysis found that subsequent tyrosine kinase inhibitor （TKI） therapy could significantly reduce the risk of mortality of patients in RTOG-RPA Class IⅡ （HR =0.411,95% CI =0.183-）.923,P =0.031） or with a GPA score of 1.5-2.5 （HR =0.420,95% CI =0.182-0.968,P =0.042）.However,none of the subgroups stratified according to RTOG-RPA or GPA benefited from the additional conventional ***：RTOG-RPA and GPA may be useful to identify beneficial populations in NSCLC patients with BM ifTKIs were chosen as postradiation systemic therapy.