title: [Timing of Whole Brain Radiotherapy on Survival of Patients with EGFR-mutated  Non-small Cell Lung Cancer and Brain Metastases].
abstract: BACKGROUND
  There is no high-level evidence for the time of whole brain radiotherapy (WBRT) for patients with epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) and brain metastases. The aim of this study is to assess the appropriate timing of WBRT for patients with EGFR-mutated NSCLC and brain metastases (BM).
  
  
  METHODS
  There were 78 patients diagnosed with EGFR-mutated NSCLC and BM in Beijing Chest Hospital between August 2009 and May 2015. 48 untreated patients who received both WBRT and EGFR-tyrosine kinase inhibitors (TKIs) therapy. Prognostic factors of intracranial progression-free survival (PFS) and overall survival (OS) were identified by Cox proportional hazards modeling.
  
  
  RESULTS
  Intracranial objective response rate was 81.3% and disease control rate was 93.8%. Median intracranial PFS was 10 months. Median OS was 18 months. Multivariate analysis of intracranial PFS revealed that Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0-1 (HR=30.436, 95%CI: 4.721-196.211, P<0.001) and early WBRT (HR=3.663, 95%CI: 1.657-8.098, P=0.001) had a better intracranial PFS. Multivariate analysis of OS revealed that PS 0-1 (HR=57.607, 95%CI: 6.135-540.953, P<0.001), early WBRT (HR=2.757, 95%CI: 1.140-6.669, P=0.024), and stereotactic radiosurgery (HR=5.964, 95%CI: 1.895-18.767, P=0.002) were independent prognostic factors of OS.
  
  
  CONCLUSIONS
  Early WBRT combined with EGFR-TKIs can improve outcomes of patients with EGFR-mutated NSCLC and BM, but it needs to be confirmed by large-sample-size and multicenter prospective clinical trials.
authors: Department of Radiotherapy, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Guimei
authors: G
authors: Liu
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Xinyong
authors: X
authors: Zhang
authors: Department of Radiotherapy, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Cuimeng
authors: C
authors: Tian
authors: Department of Radiotherapy, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Guangrong
authors: G
authors: Xia
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Ping
authors: P
authors: Liu
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Quan
authors: Q
authors: Zhang
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Xi
authors: X
authors: Li
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Hui
authors: H
authors: Zhang
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Na
authors: N
authors: Qin
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Jinghui
authors: J
authors: Wang
authors: Department of Medical Oncology, Beijing Chest Hospital, Capital Medicine University, Beijing  Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
authors: Shucai
authors: S
authors: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D016371:Cranial Irradiation / Q000009:adverse effects; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D066246:ErbB Receptors