Treatment And Prognosis Analysis Of 60 Cases Of Different EGFR Mutations Status In Non-small Cell Lung Cancer With Brain Metastasis

BackgroundLung cancer is one of the tumor that the world's highest morbidity and mortality.Non-small-cell lung cancer(NSCLC)accounts for roughly 85%of all lung cancer.In non-small cell lung cancer,brain is the most common distant metastases location.Patients will have poor prognosis when brain metastases,the median overall survival of natural survival is only a month,the median overall survival after using glucocorticoid may be extended to 2 months,and the median overall survival may be extended to 3-6 months if accept the whole brain radiotherapy.The epidermal growth factor receptor tyrosine kinase inhibitor brought new hope for patients with NSCLC.It is worth mentioning that different mutation state of the epidermal growth factor receptor,there will be significantly different prognosis.PurposeTo explore different EGFR-TKIs drug curative effect of different EGFR mutation status and different prognosis factors,here we made a retrospective analysis of 60 cases of brain metastases patients from non-small cell lung cancer who have taken EGFR-TKIs.MethodSelect 60 cases of brain metastases of non-small cell lung cancer patients from January 1,2013 to January 1,2016 in Shandong Province Tumor Hospital make a retrospective analysis.Primary tumors were confirmed by pathology,brain metastases were confirmed by imaging(cranial CT or MRI),all patients taken orally the first generation EGFR tyrosine kinase inhibitors.Statistic disease control rates and objective efficiently.The long-term curative effect is mainly evaluation progression free survival,overall survival and 1 year,2 years and 3 years of survival rate.Multi-factor analysis prognosis factors of progression-fee survival and overall survival.Result1.EGFR mutation positive group has a higher objective response rate(ORR)(48.1%vs 9.1%,P?0.001)than the EGFR utation or unknown group,there has a significant statistical differences between the two groups.In disease control rates(DCR),there was no significant statistical differences between the two groups(85.2%vs 81.8%,P = 0.728).2.The median progression-free survival(PFS)of the EGFR mutation positive group was 17.000 months,95%confidence interval(CI)was 9.608 to 24.392.The median progression-free survival(PFS)of the EGFR mutation negative or unknown group was 8.000 months,95%confidence interval(CI)was 6.042 to 9.958.There was a significant statistically difference between the two groups(17.000 vs 8.000,P = 17.000).3.The median overall survival(OS)of the EGFR mutation positive group was 26.000 months,95%confidence interval(CI)18.804 to 33.196.The median overall survival(OS)of the EGFR mutation negative or unknown group was 20.000 months,95%confidence interval(CI)16.732 to 23.268.There was significant statistically difference between the two groups(26.000 vs 20.000,P?26.000).EGFR mutation positive group of brain metastases after 1 year survival rate was 92.6%,2 year survival rate was 55.6%,3 year survival rate was 29.6%.EGFR mutation negative or unknown group of brain metastases after 1 year survival rate was 66.7%,2 year survival rate was The 1 year survival rate,2 year survival rate,3 year survival rate have obvious difference(P value were 0.015,0.015,0.015).4.Multi-factor analysis showed that age,KPS score,EGFR mutation,brain metastases have symptoms or not were the independent prognostic factors influencing the PFS.Multi-factor analysis showed that age,KPS score,EGFR mutation status,symptoms of extra cranial before brain metastases whether control or not,other treatment of brain metastases were independent prognostic factors for brain metastases after the median OS.Conclusion1.Sensitive EGFR mutation has higher objective response rate.EGFR positive mutation didn't improve disease control rates.2.Sensitive EGFR mutation of NSCLC patients with brain metastases has a longer progression-free survival and overall survival.3.EGFR positive mutation increased 1 year,2 years and 3 year survival rate than negative or unknown.4.Multi-factor analysis showed that age,KPS score,EGFR mutation,whether extracranial control before brain metastases were the independent prognostic factors influencing the PFS.Multi-factor analysis showed that age,KPS score,EGFR mutation status,symptoms of extra cranial before brain metastases whether control or not,other treatment of brain metastases were independent prognostic factors for brain metastases after the median OS.