Study On The Efficacy And Safety Of EGFR-TKIs Combined With Whole Brain Radiotherapy In Brain Metastasis Of Lung Adenocarcinoma

Background: The purpose of this study was to analyze the efficacy and safety of EGFR-TKIs combined with whole brain radiotherapy in brain metastasis from non-small cell lung adenocarcinoma.Methods:51 patients with the brain metastasis of lung adenocarcinom diagnosed in the affiliated hospital of Qinghai university from January 2015 to December 2018 were enrolled and grouped according to the treatment status.Patients were divided into EGFR-TKIs group,radiotherapy plus EGFR-TKIs group and radiotherapy followed by EGFR-TKIs group.Clinicopathological data including gender,age,smoking history,time of brain metastasis and type of drugs were collected and followed up.Cranial MRI information was used as the data source for the efficacy evaluation of intracranial lesions,and the treatment-related side effects were classified according to the NCI-CTCAE,and the clinical data of patients’ intracranial lesions efficacy evaluation and systemic side effects were analyzed.Result: 1.51 patients were enrolled in this study.Among them,9 cases in the EGFR-TKIs group,the median i PFS was 5.060 months(95% CI 3.236-6.884),and the average i PFS was 4.794 months(95% CI 3.053-6.535).25 cases in the radiotherapy plus EGFR-TKIs group,the median i PFS in this group was 7.230 months(95% CI 3.723-10.737),and the average i PFS was 6.982 months(95% CI 5.274-8.689).17 cases in the radiotherapy flowed by EGFR-TKIs group,the median i PFS in the group was 7.130 months(95% CI 4.807-9.453),and the mean i PFS was 8.569 months(95% CI 6.155-10.985).2.Age,gender,smoking history and time of occurrence in brain metastasis had no statistical significance on i PFS(P>0.05).The efficacy of radiotherapy followed by EGFR-TKIs group was better than that of the EGFR-TKIs group.The difference was statistically significant(P=0.031).3.There was no statistically significant difference in the incidence of fatigue and rash between the different treatment groups(P>0.05).Conclusion: 1.Age,gender,smoking history and time of occurrence in brain metastasis had no statistical significance on i PFS.2.The efficacy of radiotherapy followed by EGFR-TKIs group was better than that of the EGFR-TKIs group.3.The incidence of high cranial pressure in the radiotherapy plus EGFR-TKIs group was higher than that in the radiotherapy followed by EGFR-TKIs group.