title: Leptomeningeal Metastases in Patients with NSCLC with EGFR Mutations.
abstract: Leptomeningeal metastases (LM) have increased in patients with NSCLC, and prognostic factors and outcomes for LM with EGFR gene mutations have not been well studied.
  
  
  
  We retrospectively analyzed patients with lung cancer from January 2011 to June 2015 at our institute. Treatments and clinical outcomes of LM were reviewed.
  
  
  
  LM were diagnosed in 184 (3.4%) of 5387 patients with lung cancer. Patients with LM harboring EGFR mutations (9.4%) were significantly more frequent than those with wild-type EGFR (1.7% [p < 0.001]). The median overall survival (OS) after LM was 8.7 months (95% confidence interval [CI]: 7.3-10.1). Among the 109 patients with common EGFR mutations, the 88 patients who received tyrosine kinase inhibitor (TKI) therapy demonstrated longer OS than those who did not (10.0 months versus 3.3 months [p < 0.001]), but 42 patients who underwent whole brain radiotherapy (WBRT) did not show longer OS than those without WBRT, and a combination of WBRT and TKIs did not add any survival benefit beyond that in patients receiving only TKIs. A multivariate analysis indicated that TKI therapy (p < 0.001, hazard ratio = 0.218) was an independent predictor of favorable survival, whereas poor Eastern Cooperative Oncology Group performance status (p < 0.001, hazard ratio = 3.657) was a predictor of poor survival.
  
  
  
  LM were much more frequent in patients with NSCLC harboring EGFR mutations. EGFR TKIs were the optimal treatment for LM, and active treatment with WBRT did not prolong OS for EGFR-mutated patients.
authors.affiliation: Guangdong Cardiovascular Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China; Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Yang-Si
authors.initials: YS
authors.lastname: Li
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Ben-Yuan
authors.initials: BY
authors.lastname: Jiang
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Jin-Ji
authors.initials: JJ
authors.lastname: Yang
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Tu
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Wei-Bang
authors.initials: WB
authors.lastname: Guo
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
authors.forename: Hong-Hong
authors.initials: HH
authors.lastname: Yan
authors.affiliation: Guangdong Lung Cancer Institute, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China. Electronic address: syylwu@live.cn.
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000556:secondary*; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D055756:Meningeal Carcinomatosis / Q000473:pathology / Q000556:secondary*; D008875:Middle Aged; D009154:Mutation; D012189:Retrospective Studies
chemical_list: D066246:ErbB Receptors
keywords: EGFR mutations; Epidermal growth factor receptor tyrosine kinase inhibitor; Leptomeningeal metastases; NSCLC