Mariacarmela Santarpia1, Giuseppe Altavilla1, Nicolo Borsellino2, Andrea Girlando3, Gianfranco Mancuso4, Stefano Pergolizzi5, Dario Piazza6, Antonio Pontoriero5, Maria Rosaria Valerio7, Vittorio Gebbia8,9. 1. Medical Oncology Unit, Depart. of Human Pathology "G. Barresi", University of Messina, Messina, Italy. 2. Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo, Italy. 3. Radiotherapy Unit, Istituto Clinico Humanitas, Catania, Italy. 4. Medical Oncology and Supportive Care Unit, La Maddalena Cancer Center, Palermo, Italy. 5. Unit of Radiation Oncology, Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, Messina, Italy. 6. GSTU Foundation for Cancer Research, Palermo, Italy. 7. Medical Oncology Unit, Department of Oncology, University of Palermo, Palermo, Italy. 8. Medical Oncology and Supportive Care Unit, La Maddalena Cancer Center, Palermo, Italy vittorio.gebbia@gmail.com. 9. PROMISE Department, University of Palermo, Palermo, Italy.
Abstract
BACKGROUND/AIM: Local ablative treatments for oligo-progressive, EGFR mutated non-small cell lung cancer (mut-NCSLC) may improve long-term disease control and survival. We analyzed the efficacy of hypo-fractionated, high-dose radiation therapy (HDRT), in association with prolonged EGFR tyrosine kinase inhibitors (TKI) in oligo-progressive, EGFR mutant-NSCLC. PATIENTS AND METHODS: Progression-free survival-1 (PFS-1, date from initiation of TKI therapy until oligo-progression or death), and progression-free survival-2 (PFS-2, date of focal progression until further progression or death) were evaluated. RESULTS: Thirty-six patients were analyzed. The median PFS 1 was 12.5 months. HDHRT consisted of intensity-modulated RT and stereotactic RT in 23 (64%) and 13 (36%) patients respectively. The median PFS 2 was 6.3 months. Overall survival was 38.7 months. CONCLUSION: Hypo-fractionated HDRT plus TKI therapy, is associated with a significant prolongation of disease control (overall PFS: 18.8 months), with manageable side effects. These real-world data support the use of local ablative approaches in oligo-progressive EGFR mut-NSCLC. Copyright
BACKGROUND/AIM: Local ablative treatments for oligo-progressive, EGFR mutated non-small cell lung cancer (mut-NCSLC) may improve long-term disease control and survival. We analyzed the efficacy of hypo-fractionated, high-dose radiation therapy (HDRT), in association with prolonged EGFR tyrosine kinase inhibitors (TKI) in oligo-progressive, EGFR mutant-NSCLC. PATIENTS AND METHODS: Progression-free survival-1 (PFS-1, date from initiation of TKI therapy until oligo-progression or death), and progression-free survival-2 (PFS-2, date of focal progression until further progression or death) were evaluated. RESULTS: Thirty-six patients were analyzed. The median PFS 1 was 12.5 months. HDHRT consisted of intensity-modulated RT and stereotactic RT in 23 (64%) and 13 (36%) patients respectively. The median PFS 2 was 6.3 months. Overall survival was 38.7 months. CONCLUSION:Hypo-fractionated HDRT plus TKI therapy, is associated with a significant prolongation of disease control (overall PFS: 18.8 months), with manageable side effects. These real-world data support the use of local ablative approaches in oligo-progressive EGFR mut-NSCLC. Copyright
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