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Radiology and Oncology

The Journal of Association of Radiology and Oncology

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Volume 48, Issue 2

Issues

Brain metastases in lung adenocarcinoma: impact of EGFR mutation status on incidence and survival

Karmen Stanic / Matjaz Zwitter
  • Department of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia / Faculty of Medicine, University of Maribor, Slovenia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Nina Turnsek Hitij / Izidor Kern / Aleksander Sadikov / Tanja Cufer
Published Online: 2014-04-25 | DOI: https://doi.org/10.2478/raon-2014-0016

Abstract

Background. The brain represents a frequent progression site in lung adenocarcinoma. This study was designed to analyse the association between the epidermal growth factor receptor (EGFR) mutation status and the frequency of brain metastases (BM) and survival in routine clinical practice.

Patients and methods. We retrospectively analysed the medical records of 629 patients with adenocarcinoma in Slovenia who were tested for EGFR mutations in order to analyse the cumulative incidence of BM, the time from the diagnosis to the development of BM (TDBM), the time from BM to death (TTD) and the median survival.

Results. Out of 629 patients, 168 (27%) had BM, 90 patients already at the time of diagnosis. Additional 78 patients developed BM after a median interval of 14.3 months; 25.8 months in EGFR positive and 11.8 months in EGFR negative patients, respectively (p = 0.002). EGFR mutations were present in 47 (28%) patients with BM. The curves for cumulative incidence of BM in EGFR positive and negative patients demonstrate a trend for a higher incidence of BM in EGFR mutant patients at diagnosis (19% vs. 13%, p = 0.078), but no difference later during the course of the disease. The patients with BM at diagnosis had a statistically longer TTD (7.3 months) than patients who developed BM later (3.1 months). The TTD in EGFR positive patients with BM at diagnosis was longer than in EGFR negative patients (12.6 vs. 6.8, p = 0.005), while there was no impact of EGFR status on the TTD of patients who developed BM later.

Conclusions. Except for a non-significant increase of frequency of BM at diagnosis in EGFR positive patients, EGFR status had no influence upon the cumulative incidence of BM. EGFR positive patients had a longer time to CNS progression. While EGFR positive patients with BM at diagnosis had a longer survival, EGFR status had no influence on TTD in patients who developed BM later during the course of disease.

Keywords: brain metastases; lung adenocarcinoma; EGFR mutations

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About the article

Received: 2013-12-24

Accepted: 2014-03-03

Published Online: 2014-04-25

Published in Print: 2014-06-01


Citation Information: Radiology and Oncology, Volume 48, Issue 2, Pages 173–183, ISSN (Online) 1581-3207, ISSN (Print) 1318-2099, DOI: https://doi.org/10.2478/raon-2014-0016.

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© by Karmen Stanic. This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. BY-NC-ND 3.0

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