Tyrosine Kinase Inhibitor Resistance Increased the Risk of Cerebral Radiation Necrosis After Stereotactic Radiosurgery in Brain Metastases of Non-small-Cell Lung Cancer: A Multi-Institutional Retrospective Case-Control Study

Frontiers in Oncology

Liyuan Tao¹  Xin Wang²  Enmin Wang²  Hongqing Zhuang³  Joe Y. Chang⁴  Siyu Shi⁵  Zhiyong Yuan⁶ 

[1] Clinical Epidemiology Department, Peking University Third Hospital, Beijing, China;Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China;Department of Radiation Oncology, Peking University Third Hospital, Beijing, China;Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States;Stanford University School of Medicine, Stanford, CA, United States;Tianjin Key Laboratory of Cancer Prevention and Therapy, Department of Radiotherapy, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China;

关键词: cerebral radiation necrosis;    tyrosine kinase inhibitor;    brain metastasis;    epidermal growth factor receptor;    stereotactic radiosurgery;   

DOI  :  10.3389/fonc.2020.00012

来源: DOAJ

【 摘 要 】

Objective: This study aimed to investigate the relationship between the timing of stereotactic radiosurgery (SRS) intervention and the complications of cerebral radiation necrosis (CRN) in patients with brain metastases of lung adenocarcinoma who received tyrosine kinase inhibitor (TKI) treatment.Methods: A total of 361 targets from 257 patients with brain oligometastases of lung adenocarcinoma who received CyberKnife treatment between 2010 and 2017 were retrospectively collected from three CyberKnife centers. The difference in brain necrosis between patients with or without TKI application was statistically counted. Logistic regression analysis was used to analyze the effect of applying TKI on the occurrence of CRN in patients and the effect of SRS before and after TKI resistance on CRN.Results: The rate of CRN in the TKI group was significantly higher than that in the non-TKI group. The incidence of brain necrosis in patients undergoing SRS after drug resistance was significantly higher than that in patients undergoing SRS before drug resistance. Regression analysis showed that combination of TKI with SRS, and SRS after TKI resistance were important influencing factors for CRN.Conclusion: Performing the SRS for brain metastases after TKI resistance worsened the occurrence of CRN of patients treated with TKI.Clinical Trial Registration: Chinese clinical trial registry, http://www.chictr.org.cn/edit.aspx?pid=38395&htm=4, Registration number: ChiCTR1900022750.

【 授权许可】

Unknown