Background/Objectives: Brain metastases (BrMs) are a common complication of non-small cell lung cancer (NSCLC), present in up to 50% of patients. While the treatment of BrMs requires a multidisciplinary approach with surgery, radiotherapy (RT), and systemic therapy, the advances in molecular sequencing have improved outcomes in patients with targetable mutations. With a push towards the molecular characterization of cancers, we evaluated the outcomes by treatment modality at our institution with respect to prioritizing RT and targeted therapies.Methods: We identified the patients with NSCLC BrMs treated with surgical resection. The primary endpoints were in-brain freedom from progression (FFP) and overall survival (OS). The secondary endpoint included index lesion recurrence. The tumor molecular profiles were reviewed. The outcomes were evaluated by treatment modality: surgery followed by adjuvant RT and/or adjuvant systemic therapy.Results: In total, 155/272 (57%) patients who received adjuvant therapy with adequate follow-up were included in this analysis. The patients treated with combination therapy vs. monotherapy had a median FFP time of 10.72 months vs. 5.38 months, respectively (p= 0.072). The patients of Hispanic/Latino vs. non-Hispanic/Latino descent had a statistically significant worse OS of 12.75 months vs. 53.15 months, respectively (p= 0.015). The patients who received multimodality therapy had a trend towards a reduction in index lesion recurrences (χ2test,p= 0.063) with a statistically significant improvement in the patients receiving immunotherapy (χ2test,p= 0.0018).Conclusions: We found that systemic therapy combined with RT may have an increasing role in delaying the time to progression; however, there was no statistically significant relationship between OS and treatment modality.
背景/目的：脑转移是非小细胞肺癌的常见并发症，发生率高达50%。虽然脑转移的治疗需要手术、放疗和全身治疗相结合的多学科综合治疗，但分子测序技术的进步已显著改善携带可靶向突变患者的预后。随着肿瘤分子分型理念的推进，本研究旨在评估本机构不同治疗模式（重点关注放疗与靶向治疗）的临床结局。 方法：我们筛选了接受手术切除的非小细胞肺癌脑转移患者。主要研究终点为颅内无进展生存期和总生存期，次要终点包括靶病灶复发情况。研究团队系统回顾了肿瘤分子谱特征，并根据治疗模式（手术联合辅助放疗和/或辅助全身治疗）进行疗效分析。 结果：本研究共纳入272例患者中155例（57%）接受辅助治疗且随访资料完整的病例。联合治疗组与单药治疗组的中位无进展生存期分别为10.72个月和5.38个月（p=0.072）。西班牙裔/拉丁裔患者较非西班牙裔/拉丁裔患者总生存期显著缩短（12.75个月 vs 53.15个月，p=0.015）。接受多模式治疗的患者靶病灶复发率呈下降趋势（χ²检验，p=0.063），其中接受免疫治疗的患者改善尤为显著（χ²检验，p=0.0018）。 结论：研究发现全身治疗联合放疗可能对延缓疾病进展具有积极作用，但总生存期与治疗模式之间未发现统计学显著相关性。
肿瘤(癌症)患者之家