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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

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Chinese Medical Journal 2018年第10期131卷 1206-1213页

作者： Shuai Liu Peng Chen Yan-Wei Liu Xue-Nan GU Xiao-Guang Qiu Bo Li 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

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.

关键词： Chemotherapy Non-Small Cell Lung Cancer Recursive Partitioning Analysis Stereotactic Radiosurgery Tyrosine Kinase Inhibitors whole-brain radiation Therapy

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