title: Overall survival and prognostic factors in patients with spinal metastases from lung cancer treated with and without epidermal growth factor receptor tyrosine kinase inhibitors.
abstract: BACKGROUND
  Evaluation of the prognosis in patients with spinal metastases is important in decision making regarding surgical treatment. The purpose of this study was to investigate overall survival in patients with spinal metastases from lung cancer by histological subtype, and to investigate prognostic factors in patients treated with and without epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs).
  
  
  METHODS
  The data from 135 patients diagnosed with spinal metastases from lung cancer were retrospectively evaluated. The 88 patients with adenocarcinoma were divided into two groups according to whether the lung cancer was treated with or without EGFR-TKIs-the EGFR-TKI group (n = 43) and the non-EGFR-TKI group (n = 45).
  
  
  RESULTS
  The overall median survival time was 11.3 months for those with adenocarcinoma, 5.3 months for squamous cell carcinoma, and 3.9 months for small cell carcinoma. Overall survival in the EGFR-TKI group (median 21.4 months) was significantly longer than in the non-EGFR-TKI group (median 6.1 months). In univariate analysis, poor performance status was a poor prognostic factor in the non-EGFR-TKI group. However, performance status and other variables were not significant prognostic factors in the EGFR-TKI group.
  
  
  CONCLUSIONS
  Median overall survival was longer in patients with spinal metastases from lung cancer treated with EGFR-TKIs compared with those treated without EGFR-TKIs. Poor performance status or other prognostic factors were not associated with poor overall survival in the group treated with EGFR-TKIs.
authors.affiliation: Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima Higasiyodogawa-ku, Osaka, 533-0024, Japan. s.dohzono@med.osaka-cu.ac.jp.
authors.forename: Sho
authors.initials: S
authors.lastname: Dohzono
authors.affiliation: Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima Higasiyodogawa-ku, Osaka, 533-0024, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Sasaoka
authors.affiliation: Department of Orthopaedic Surgery, Yodogawa Christian Hospital, 1-7-50 Kunijima Higasiyodogawa-ku, Osaka, 533-0024, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Takamatsu
authors.affiliation: Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D013125:Spinal Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000556:secondary
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: Epidermal growth factor receptor; Lung cancer; Molecular targeted therapy; Prognosis; Spinal metastasis