title: Frequency of brain metastases in non-small-cell lung cancer, and their association with epidermal growth factor receptor mutations.
abstract: BACKGROUND
  The brain is a frequent site of metastases from non-small-cell lung cancer (NSCLC). We analyzed the frequency of brain metastases (BMs) from NSCLC in the era of magnetic resonance images, and evaluated the correlation between epidermal growth factor receptor (EGFR) mutations and BMs among East Asian patients.
  
  
  METHODS
  Frequency, number, and size of BMs, and survival of 1,127 NSCLC patients were retrospectively reviewed. Mutation status of EGFR was evaluated in all cases, and its association with BMs was statistically evaluated.
  
  
  RESULTS
  EGFR mutations were found for 331 cases (29.4 %). BM was the cause of primary symptoms for 52 patients (4.6 %), and found before initiation of treatment for 102 other patients (9.1 %); In addition to these 154 patients, 107 patients (9.5 %) developed BMs, giving a total of 261 patients (23.2 %) who developed BMs from 1,127 with NSCLC. BM frequency was higher among EGFR-mutated cases (31.4 %) than EGFR-wild cases (19.7 %; odds ratio: 1.86; 95 % confidence interval (CI) 1.39-2.49; P < 0.001). BMs from EGFR-mutated NSCLC were small, but often became disseminated. EGFR mutations accounted for 39.9 % of BMs, but patient survival after BMs was significantly longer for EGFR-mutated cases than for EGFR-wild cases (hazard ratio: 2.23; 95 % CI 1.62-3.10; P < 0.001).
  
  
  CONCLUSIONS
  Patients with EGFR-mutated NSCLC were more likely to develop BMs, but apparently also survived longer after BMs.
authors.affiliation: Division of Neurological Surgery, Chiba Cancer Center, Chiba, 260-8717, Japan, tiuchi@chiba-cc.jp.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Iuchi
authors.forename: Masato
authors.initials: M
authors.lastname: Shingyoji
authors.forename: Meiji
authors.initials: M
authors.lastname: Itakura
authors.forename: Sana
authors.initials: S
authors.lastname: Yokoi
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Moriya
authors.forename: Hajime
authors.initials: H
authors.lastname: Tamura
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Hironori
authors.initials: H
authors.lastname: Ashinuma
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Sakaida
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Iizasa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001932:Brain Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics* / Q000556:secondary; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009154:Mutation
chemical_list: D066246:ErbB Receptors