ABSTRACT
PURPOSE: The role of thoracic radiotherapy in the treatment of metastatic EGFR mutant non-small cell lung cancer (NSCLC) patients in literature data are insufficient.The purpose of this study was to examine the effectiveness of upfront thoracic radiotherapy in metastatic EGFR mutant NSCLC patients treated with chemotherapy or tyrosine kinase inhibitors (TKI). METHODS: This study was designed as a hospital-based retrospective observational case-series study. A total of 141 patients with metastatic EGFR mutant NSCLC who were followed in two different oncology centers in Turkey between 2014 and 2019 have been included into this study. RESULTS: The median patient age was 63 years (range 35-91). EGFR mutation results of exon 19 deletion, exon 21 mutation and exon 18 mutation were found in 82 (58.2%), 56 (39.7%) and 3 (2.1%) patients, respectively.The median follow-up time was 22 months and 94 (33.3%) patients died during follow-up. Median overall survival (OS) was 26 months and progression free survival (PFS) (for first line treatment) was 10 months for the whole cohort, respectively. Radiotherapy was given to the primary tumor site in 32 (22.6%) patients. Patients receiving radiotherapy to primary tumor site had better OS than those who had not (31 versus 23 months respectively, p=0.02). Survival advantage was also seen for patients group taking TKI at upfront setting (33 versus 23 months respectively, p=0.05). CONCLUSION: In this study, we have shown that upfront thoracic radiotherapy to primary lesion as combination with EGFR-TKI treatment may improve the outcome in advanced stage IV NSCLC patients harboring EGFR mutations.
Subject(s)
Carcinoma, Non-Small-Cell Lung/radiotherapy , Lung Neoplasms/radiotherapy , Adult , Aged , Aged, 80 and over , Carcinoma, Non-Small-Cell Lung/genetics , Carcinoma, Non-Small-Cell Lung/pathology , Carcinoma, Non-Small-Cell Lung/secondary , ErbB Receptors/genetics , Humans , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Middle Aged , Mutation , Neoplasm Staging , Radiotherapy/methods , Retrospective Studies , Treatment OutcomeABSTRACT
PURPOSE: Infectious diseases are a major cause of morbidity and mortality in cancer patients. Tumor-induced inflammatory responses may increase the value of classical inflammatory markers in blood, so these markers may not be as useful in cancer patients as in non-cancer patients. Serum procalcitonin (PCT) is a sensitive and specific biomarker for severe infection, and has been shown to be unaffected by tumor-induced inflammatory response. In this study we aimed to evaluate the possible role of PCT in mortality in cancer patients with infection. METHODS: In total, 104 consecutive adult cancer patients who presented with fever (body temperature ≥ 38.3° C or ≥ 38° C on two consecutive measurements) during follow-up and needing hospitalization for infection were enrolled in this study. RESULTS: The majority (72%) of the patients were male. The most common diagnosis and type of infection were lung cancer (40.4%) and pneumonia (56.7%), respectively. The overall mortality rate was 17%. Statistical analysis showed a significant relationship between PCT levels and mortality (p=0.001), but not between classical inflammatory markers and mortality (p>0.05). The mortality rate of patients with a PCT value > 2 ng/mL was 34.3%, compared with 9.6% in patients with a PCT below this value (p=0.005). Furthermore, PCT predicted in-ward cancer patient mortality with a sensitivity of 66% and a specificity of 76%. CONCLUSION: PCT is a unique serum biomarker significantly related to infection-related mortality and predicts mortality with a relatively high sensitivity and specificity.
