title: Safety of cranial radiotherapy concurrent with tyrosine kinase inhibitors in non-small cell lung cancer patients: A systematic review.
abstract: Recently, non-small cell lung cancer (NSCLC) has been partly subclassified into molecularly-defined oncogene "addicted" tumors for which targeted agents are available. Tyrosine kinase inhibitors (TKI) are currently approved for patients with an activating epidermal growth factor receptor (EGFR) mutation or anaplastic lymphoma kinase (ALK) rearrangement. In these patients, brain metastases are often the first site of progression while on TKI treatment. The TKI may however still be active on extra-cranial sites and clinicians are thus faced with the question if the TKI may be continued during cranial radiotherapy. Advantages of combining TKI with cranial radiotherapy would be a possible synergistic effect on the brain metastases and the prevention of a systemic disease flare-up. A disadvantage is the possibly increased risk of (neuro)toxicity. The present systematic review addresses the toxicity of combining TKI with cranial radiotherapy in NSCLC patients.
authors.affiliation: Dept. of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: lizza.hendriks@mumc.nl.
authors.forename: Lizza E L
authors.initials: LE
authors.lastname: Hendriks
authors.affiliation: Dept. of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: j.schoenmaekers@mumc.nl.
authors.forename: Janna
authors.initials: J
authors.lastname: Schoenmaekers
authors.affiliation: Dept. of Radiation Oncology (MAASTRO Clinic), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Doctor Tanslaan 12, 6229 ET Maastricht, The Netherlands. Electronic address: jaap.zindler@maastro.nl.
authors.forename: Jaap D
authors.initials: JD
authors.lastname: Zindler
authors.affiliation: Dept. of Radiation Oncology (MAASTRO Clinic), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, Doctor Tanslaan 12, 6229 ET Maastricht, The Netherlands. Electronic address: danielle.eekers@maastro.nl.
authors.forename: Danielle B P
authors.initials: DB
authors.lastname: Eekers
authors.affiliation: Dept. of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: ann.hoeben@mumc.nl.
authors.forename: Ann
authors.initials: A
authors.lastname: Hoeben
authors.affiliation: Dept. of Radiation Oncology, KU Leuven - University of Leuven, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium. Electronic address: dirk.deruysscher@uzleuven.be.
authors.forename: Dirk K M
authors.initials: DK
authors.lastname: De Ruysscher
authors.affiliation: Dept. of Pulmonary Diseases, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center+, PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: a.dingemans@mumc.nl.
authors.forename: Anne-Marie C
authors.initials: AM
authors.lastname: Dingemans
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000532:radiotherapy*; D016371:Cranial Irradiation; D018450:Disease Progression; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*
chemical_list: D047428:Protein Kinase Inhibitors
keywords: ALK; Cranial radiotherapy; EGFR; NSCLC; Neurotoxicity; Tyrosine kinase inhibitor