title: The impact of clinical outcomes according to EGFR mutation status in patients with locally advanced lung adenocarcinoma who recieved concurrent chemoradiotherapy.
abstract: OBJECTIVE
  Among patients with locally advanced lung adenocarcinoma, the frequency of epidermal growth factor receptor (EGFR) and KRAS mutations was unknown. In addition, it has not been fully evaluated about the role of these mutations treated with concurrent chemoradiotherapy (CCR).
  
  
  METHODS
  The clinical records of locally advanced lung adenocarcinoma patients treated with CCR at Shizuoka Cancer Center between September 2002 and December 2009 were reviewed.
  
  
  RESULTS
  Forty-four patients were eligible for this study. EGFR mutation was detected in 13 (29.5%) of 44 patients, and KRAS mutation was detected in 2 (6.5%) of 31 patients. Among EGFR mutation status known patients, overall response rate, median progression-free survival (PFS), and median survival time were 52.3%, 11.5 months, and 35.8 months, respectively. Overall response rate was significantly higher in EGFR mutant group than in EGFR wild-type group (76.9% vs. 41.9%, P=0.02), but this difference did not translate into a significant PFS benefit (9.6 vs. 13.2 mo, P=0.78). Locoregional relapse occured less frequently in patients with EGFR mutation than those with EGFR wild-type, but not significant (15.4% vs. 32.3%, P=0.46). Brain was the most frequent metastatic site of relapse in EGFR mutant group.
  
  
  CONCLUSIONS
  Among locally advanced lung adenocarcinoma, EGFR mutation was detected in 29.5% and KRAS mutation was detected in 6.5%. We were not able to detect a difference in PFS or overall survival between EGFR mutant and wild-type patients treated with conventional CCR. Locoregional relapse was approximately half in the EGFR mutant group compared with the EGFR wild-type group; however, this finding did not reach statistical significance.
authors.affiliation: Divisions of *Thoracic Oncology †Drug Discovery and Development ‡Diagnostic Radiology §Radiation Oncology ∥Diagnostic Pathology, Shizuoka Cancer Center, Shizuoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Akamatsu
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Kaira
authors.forename: Haruyasu
authors.initials: H
authors.lastname: Murakami
authors.forename: Masakuni
authors.initials: M
authors.lastname: Serizawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Koh
authors.forename: Akira
authors.initials: A
authors.lastname: Ono
authors.forename: Takehito
authors.initials: T
authors.lastname: Shukuya
authors.forename: Asuka
authors.initials: A
authors.lastname: Tsuya
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Kenmotsu
authors.forename: Tateaki
authors.initials: T
authors.lastname: Naito
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Endo
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Harada
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yamamoto
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009364:Neoplasm Recurrence, Local / Q000235:genetics; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors