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Lei Zhao

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    Lunch & Poster Display session (ID 58)

    • Event: ELCC 2019
    • Type: Poster Display session
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 4/11/2019, 12:30 - 13:00, Hall 1
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      131P - Upfront whole brain radiotherapy for multiple brain metastases in patients with EGFR-mutant lung adenocarcinoma (ID 268)

      12:30 - 13:00  |  Author(s): Lei Zhao

      • Abstract
      • Slides


      This study aimed to evaluate the efficacy of upfront whole-brain radiotherapy (WBRT) in epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma with multiple brain metastases (BM).

      a9ded1e5ce5d75814730bb4caaf49419 Methods

      195 patients with EGFR mutations who had multiple BM at preliminary diagnosis were included and retrospectively reviewed in this study. Patients were administered for following treatments in a multi-disciplinary setting: upfront WBRT followed by EGFR-TKI, concurrent EGFR-TKI and WBRT and upfront EGFR-TKI followed by WBRT. A disease specific graded prognostic assessment (GPA) was performed for all the patients. The treatment response and overall survival (OS) were evaluated.

      20c51b5f4e9aeb5334c90ff072e6f928 Results

      The median OS of these patients was 27 months. Objective response rate (ORR) was much better in upfront WBRT group than other two groups (P = 0.004). Moreover, patients receiving upfront WBRT (n = 67) had longer OS than the concomitant group (36 vs. 25 months; P = 0.006) and the upfront EGFR-TKI group (36 vs. 25 months; P < 0.0001). The prognosis of patients with different GPA scores significantly differed (p < 0.0001). In subgroup of concomitant and upfront EGFR-TKI groups, patients with higher GPA scores (2-3) had more favorable prognosis compared with those with lower scores (0-1.5) (27 versus 25 months; P = 0.023). Patients receiving EGFR-TKI concurrently with WBRT had superior OS than those receiving upfront EGFR-TKI with high GPA scores. (37 versus 17 months; P = 0.023).

      fd69c5cf902969e6fb71d043085ddee6 Conclusions

      The use of upfront WBRT in EGFR-mutated lung adenocarcinoma patients with multiple BM improves ORR and OS. More importantly, patients with high GPA scores are recommended to receive WBRT soon after EGFR-TKI therapy.

      b651e8a99c4375feb982b7c2cad376e9 Legal entity responsible for the study

      The authors.

      213f68309caaa4ccc14d5f99789640ad Funding

      National Natural Science Foundation of China (No.81502450) and Science and Technology Commission of Shanghai Municipality, China (No.18441904700).

      682889d0a1d3b50267a69346a750433d Disclosure

      All authors have declared no conflicts of interest.


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