ESTRO 2024 - Abstract Book

S1730

Clinical - Lung

ESTRO 2024

Results:

Before PSM, the median OS was 48.8months, while the median iPFS was 14.2months. The median OS of patients in EGFR-TKI+craniocerebral radiotherapy group and EGFR-TKI alone group was 50.4 months and 44.0 months respectively, and there was no significant difference (p=0.1623).After PSM, a total of 346 patients were successfully matched, with 173 patients in each group. The median OS was 47.3months, while the median iPFS was 13.1months According to PSM analysis, the median OS of EGFR-TKIs+craniocerebral radiotherapy group and EGFR-TKI alone group was 52.0 months and 43.2 months respectively, and there was significant difference between the two groups (p=0.0363). A total of 417 patients enrolled this part of the study who received craniocerebral radiotherapy.For OS analysis of patients in upfront-group and delay-group showed that the median OS was 44.3 and 58.9 months respectively. There was significant difference in median OS between upfront-group and delay-group (p =0.0234). In addition, patients were divided into group A (Lung-molGPA 1-2) and group B(Lung-molGPA 2.5-4) according to Lung-molGPA score. For group A, the median OS of upfront-group and delay-group was 27 and 42.1 months, respectively. In the low score group of Lung-molGPA, there was significant difference between upfront-group and delay-group (p = 0.0019).For patients in group B, there was no significant difference in OS between the two groups (p = 0.9642). The median OS of the two groups was 59.40 and 67.70 months, respectively.

Conclusion:

EGFR-TKI combined with craniocerebral radiotherapy is more beneficial to the survival of patients with EGFR mutant lung adenocarcinoma with craniocerebral metastasis than EGFR-TKI alone. The importance of craniocerebral radiotherapy in the treatment of EGFR mutant lung adenocarcinoma with craniocerebral metastasis was emphasized.In the low score group of Lung-molGPA that patients with worse clinical conditions, should be given EGFR-TKIs-based systematic treatment.In patients with high Lung-molGPA score and better clinical condition,according to the results of iPFS analysis, craniocerebral radiotherapy as early as possible can obtain a longer intracranial progression-free survival.

Keywords: EGFR-Mutant,CRT,lung adenocarcinoma

References:

1.Deng G, Zhang Y, Ke J, Wang Q, Qin H, Li J, et al. Effect of brain radiotherapy

strategies on prognosis of patients with EGFR-mutant lung adenocarcinoma with

brain metastasis. J Transl Med 2021;7:503. https://doi.org/10.1186/s12967-021-

03161-1.

2.Deng G, Tan X, Li Y, et al. Effect of EGFR-TKIs combined with craniocerebral radiotherapy on the prognosis of EGFR-mutant lung adenocarcinoma patients with brain metastasis: A propensity-score matched analysis. Front Oncol. 2023;13:1049855. Published 2023 Feb 9. doi:10.3389/fonc.2023.1049