ArticleBMC cancer2024
Optimal intervention timing for craniocerebral radiotherapy in EGFR mutant lung adenocarcinoma patients with brain metastases.
Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review and network meta-analysis of first-line EGFR-TKI-based combination strategies for EGFR-mutant non-small cell lung cancer with brain metastases.Scientific reports · 2026Pooled it
- Stereotactic Radiation Therapy for Lung Cancer Brain Metastases: Dose Optimization and Prognostic Prediction via Biologically Effective Dose-Based Empirical Dose-Response Modeling and Extreme Gradient Boosting-SHapley Additive Explanations Machine Learning.Advances in radiation oncology · 2026Article
- Lung-molGPA may stratify the prognostic impact of TP53 co-mutation in EGFR-mutant lung adenocarcinoma with brain metastases: a multi-center retrospective analysis.Therapeutic advances in medical oncology · 2026Article
- The risk of radiation necrosis from combined radiotherapy and BRAF inhibitor in lung adenocarcinoma brain metastases: a comprehensive review and future perspectives.Frontiers in oncology · 2026Review
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Authors and funding
6 authors.
Funding
Abstract
backgroundIntracranial radiation in combination with EGFR targeted therapy demonstrated signals of superiority to EGFR targeted therapy alone based on several observational studies. The timing based on specific criteria is not clear, and we evaluated the efficacy of intervention timing of craniocerebral radiotherapy (RT) combined with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) on prognosis of patients with EGFR mutant lung adenocarcinoma complicated with brain metastasis.
methodsIn total, 603 patients with advanced non-small cell lung cancer (NSCLC) harboring EGFR mutations were enrolled in this retrospective study between March 2008-September 2023. Propensity score matching (PSM) was conducted to adjust for demographic and clinical covariates and to compare survival differences between the EGFR-TKI plus craniocerebral RT group and the EGFR-TKI only group. Patients were divided into upfront group and delayed group according to timing of craniocerebral RT interventions and analyses. Graded prognostic assessment for lung cancer using molecular markers (Lung molGPA), overall survival (OS), and intracranial progression-free survival (iPFS) were calculated. Kaplan-Meier was used to compare iPFS and OS in different groups.
resultsIn our study, the median overall survival (OS) was 48.8 months, and the median intracranial progression-free survival (iPFS) was 14.2 months before PSM. After PSM, the median OS of EGFR-TKIs + craniocerebral RT group and EGFR-TKI only group was 52.0 months and 43.2 months, respectively (p = 0.0363). In total of 417 patients who underwent craniocerebral RT, were enrolled subsequently and divided into groups A (Lung-molGPA 1-2) and B (Lung-molGPA 2.5-4) according to the lung-molGPA score. For group A, the median OS of upfront-group and delay-group was 27 and 42.1 months, respectively (p = 0.0019). For patients in group B, there was no significant difference in OS between the two groups (p = 0.9642).
conclusionFor patients with craniocerebral metastases of EGFR-mutant lung adenocarcinoma, combination of EGFR-TKIs and craniocerebral RT confers enhanced survival benefits. In patients with lower Lung-molGPA scores, delayed administration of craniocerebral RT is recommended to improve both iPFS and OS.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.