Impact of Radiotherapy Pattern on the Prognosis of Stage IV Lung Adenocarcinomas Harboring EGFR Mutations

Zhang, Yingyun; Wang, Wei; Xu, Xuedong; Li, Yankang; Zhang, Hui; Li, Jianbin; Li, Zhenxiang

doi:10.2147/cmar.s299563

Cited by 5 publications

(6 citation statements)

References 39 publications

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“…Some clinical studies have shown that EGFR TKIs combined with thoracic radiotherapy for advanced NSCLCs with EGFR mutation provides long-term control of primary lung tumors [6][7][8]. Our previous study also confirmed that thoracic radiotherapy was associated with prolonged median OS for this subpopulation patients [9].…”

Section: Introductionsupporting

confidence: 82%

“…This study showed that the mOS of all patients who received thoracic radiotherapy was 36.9 months. The OS of the patients was significantly prolonged as compared to those reported in previous studies, indicating that thoracic radiotherapy could significantly improve the prognosis of lung adenocarcinoma patients with EGFR mutation [ 9 ]. As a local treatment, thoracic radiotherapy could improve the disease conditions of advanced lung adenocarcinoma patients with EGFR mutation [ 17 ].…”

Section: Discussionmentioning

confidence: 80%

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Pre-radiotherapy systemic immune inflammation index associated with overall survival in patients with advanced EGFR mutant non-small cell lung cancer receiving thoracic radiotherapy

et al. 2022

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Purpose This study aimed to investigate the prognostic potential of the pre-radiotherapy systemic immune-inflammation index (SII) for the survival of advanced lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutations, which might provide a basis for optimizing the comprehensive treatment scheme. Methods A total of 111 lung adenocarcinoma patients with EGFR mutations, who received thoracic radiotherapy, were included in this retrospective study. The primary endpoint of the study was based on the overall survival (OS) of patients. The receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off value of each immune inflammation index. Kaplan–Meier analysis was performed for the comparison of OS. The Cox proportional-hazard model was used for the multivariate and univariate regression analyses to determine the correlations of prognostic factors with the disease. Results SII was divided into the high SII group (≥ 620.2; 45.95%) and the low SII group (SII < 620.2; 54.05%) based on the optimal cutoff values. The median OS rates were 53.3 and 33.3 months in the low and high SII groups, respectively, showing statistically significant differences ( hazard ratio (HR) = 0.459; 95% CI 0.286–0.736; P < 0.001). The multivariate analysis showed that, after adjusting for the significant covariates, the SII values were independently associated with the improved OS of the patients (adjusted HR = 0.444; 95% CI 0.279–0.709; P = 0.001). The low NLR values were associated with the better OS of patients (HR = 0.509; 95% CI 0.326–0.792; P = 0.005) and vice versa (HR = 0.422; 95% CI 0.213–0.836; P < 0.001). The patients in the low LMR group before radiotherapy exhibited longer OS as compared to those in the high LMR group (HR = 0.497; 95% CI 0.308–0.802; P = 0.001). Conclusions This study showed that these inflammatory indices might have an important prognostic potential for advanced lung adenocarcinoma patients with EGFR mutations, receiving thoracic radiotherapy and might provide a basis for the individualized treatment of these patients.

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Section: Introductionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 80%

Pre-radiotherapy systemic immune inflammation index associated with overall survival in patients with advanced EGFR mutant non-small cell lung cancer receiving thoracic radiotherapy

et al. 2022

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“…For the advanced NSCLC, the value of thoracic radiotherapy in the patients with EGFR mutant lung adenocarcinoma for the OS of patients has been previously investigated. The results showed that the patients, receiving thoracic radiotherapy had longer OS than those, who did not receive thoracic radiotherapy [ 18 ]. However, the effects of different radiotherapy dose schemes on the patients’ OS rates are needed to be further investigated.…”

Section: Discussionmentioning

confidence: 99%

Effect of thoracic radiotherapy dose on the prognosis of advanced lung adenocarcinoma harboring EGFR mutations

Qin

Dong

et al. 2022

BMC Cancer

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Background The aim of this study was to investigate the effects of different thoracic radiotherapy doses on OS and incidence of radiation pneumonia which may provide some basis for optimizing the comprehensive treatment scheme of these patients with advanced EGFR mutant lung adenocarcinoma. Methods Data from 111 patients with EGFR-mutant lung adenocarcinoma who received thoracic radiotherapy were included in this retrospective study. Overall survival (OS) was the primary endpoints of the study. Kaplan–Meier method was used for the comparison of OS. The Cox proportional-hazard model was used for the multivariate and univariate analyses to determine the prognostic factors related to the disease. Results The mOS rates of the patients, who received radiotherapy dose scheme of less than 50 Gy, 50–60 Gy (including 50 Gy), and 60 Gy or more were 29.1 months, 34.4 months, and 51.0 months, respectively (log-rank P = 0.011). Although trend suggested a higher levels of pneumonia cases with increasing radiation doses, these lack statistical significance (χ2 = 1.331; P = 0.514). The multivariate analysis showed that the thoracic radiotherapy dose schemes were independently associated with the improved OS of patients (adjusted hazard ratio [HR], 0.606; 95% CI, 0.382 to 0.961; P = 0.033). Conclusions For the patients with advanced EGFR-mutant lung adenocarcinoma, the radical thoracic radiotherapy dose scheme (≥ 60 Gy) could significantly prolong the OS of patients during the whole course management.

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“…The outcome data were from our most recent advancement and improvement in early detection, prevention, improved surgical procedures, neoadjuvant therapy, immunotherapy, and targeted therapy. To date, treatment of NSCLC is dependent on the stage of disease at diagnosis, and early-staged NSCLC could be surgically cured, whereas the advanced staged diseases can only be subjected to chemotherapy, radiation therapy, immunotherapy, and/or targeted therapy (Maconachie et al, 2019;Planchard et al, 2018) and their prognosis is, therefore, still poor, approximately less than 5-7% at the best according to the American Cancer Society data (https://www.cancer.org/cancer/ lung-cancer/detection-diagnosis-staging/survival-rates.html) or after advanced therapy (Zhang et al, 2021). Thus, the search and development of biomarkers for early detection and prediction of prognosis and treatment outcome are urgently needed to effectively conquer this now deadly disease clinically.…”

Section: Introductionmentioning

confidence: 99%

N6-Methyladenosine RNA Methylation Regulator-Related Alternative Splicing (AS) Gene Signature Predicts Non–Small Cell Lung Cancer Prognosis

Zhao

Cai

Zhang

et al. 2021

Front. Mol. Biosci.

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Aberrant N6-methyladenosine (m6A) RNA methylation regulatory genes and related gene alternative splicing (AS) could be used to predict the prognosis of non–small cell lung carcinoma. This study focused on 13 m6A regulatory genes (METTL3, METTL14, WTAP, KIAA1429, RBM15, ZC3H13, YTHDC1, YTHDC2, YTHDF1, YTHDF2, HNRNPC, FTO, and ALKBH5) and expression profiles in TCGA-LUAD (n = 504) and TCGA-LUSC (n = 479) datasets from the Cancer Genome Atlas database. The data were downloaded and bioinformatically and statistically analyzed, including the gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. There were 43,948 mRNA splicing events in lung adenocarcinoma (LUAD) and 46,020 in lung squamous cell carcinoma (LUSC), and the data suggested that m6A regulators could regulate mRNA splicing. Differential HNRNPC and RBM15 expression was associated with overall survival (OS) of LUAD and HNRNPC and METTL3 expression with the OS of LUSC patients. Furthermore, the non–small cell lung cancer prognosis-related AS events signature was constructed and divided patients into high- vs. low-risk groups using seven and 14 AS genes in LUAD and LUSC, respectively. The LUAD risk signature was associated with gender and T, N, and TNM stages, but the LUSC risk signature was not associated with any clinical features. In addition, the risk signature and TNM stage were independent prognostic predictors in LUAD and the risk signature and T stage were independent prognostic predictors in LUSC after the multivariate Cox regression and receiver operating characteristic analyses. In conclusion, this study revealed the AS prognostic signature in the prediction of LUAD and LUSC prognosis.

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Impact of Radiotherapy Pattern on the Prognosis of Stage IV Lung Adenocarcinomas Harboring EGFR Mutations

Cited by 5 publications

References 39 publications

Pre-radiotherapy systemic immune inflammation index associated with overall survival in patients with advanced EGFR mutant non-small cell lung cancer receiving thoracic radiotherapy

Pre-radiotherapy systemic immune inflammation index associated with overall survival in patients with advanced EGFR mutant non-small cell lung cancer receiving thoracic radiotherapy

Effect of thoracic radiotherapy dose on the prognosis of advanced lung adenocarcinoma harboring EGFR mutations

N6-Methyladenosine RNA Methylation Regulator-Related Alternative Splicing (AS) Gene Signature Predicts Non–Small Cell Lung Cancer Prognosis

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