Non-small cell lung cancer molecular alterations impact on brain metastases response to gamma knife radiosurgery: Identification of potential radiosensitive tumor phenotypes - 24/11/14
Résumé |
Introduction |
Results from clinical studies regarding the radiosensitivity of non-small cell lung cancer (NSCLC) brain metastases (BMs) are scarce and inconclusive. Indeed, little is known about the actual impact of the primary tumor molecular profile and radiological response to radiosurgery. We report here the analysis of a prospective patient cohort of NSCLC patients harboring BMs treated by gamma knife radiosurgery and investigated whether the primary tumor molecular phenotype had an actual impact on BM radiosensitivity.
Materials and methods |
Two hundred sixty three patients were enrolled between January 2010 and April 2013. Molecular profile was available for 90 patients. Local and distant brain control was determined for these 90 patients harboring 173 BMs. Radiological assessment using MRI-scans was undertaken every 3 months after radiosurgery. Patient-, tumor- and treatment-related data were included. Log-rank test and Cox regression model were used to correlate molecular profile of the primary tumor and other clinical features to intracranial radiological control.
Results |
In total, 48/90 (53.3%) of patients presented molecular alterations, 25/90 (27.8%) had KRAS mutations, 16/90 (17.8%) had EGFR mutations, 3/90 (3.3%) had ALK translocation, and 4 patients other genetic alterations. Overall, local and distant control was achieved in 83/90 (92.2%) and in 39/90 (43.4%) patients respectively. No local treatment failure was observed in EGFR mutant or ALK translocated tumor. One (4%) of the 25 KRAS mutated patients experienced a local failure. In the 42/90 patients (46.7%), local failure occurred in 4 cases (9.5%). Multivariate analysis demonstrated that EGFR mutation status and ALK translocation were independent predictors of better local control in patients treated by gamma knife radiosurgery.
Conclusion |
EGFR mutation and ALK translocation are independent prognostic factor regarding local control after Gama Knife radiosurgery in NSCLC patients with BM. The results provided here suggest that molecular profile of NSCLC patient might be taken in account in treatment decision strategy.
Le texte complet de cet article est disponible en PDF.Plan
Vol 60 - N° 6
P. 333 - décembre 2014 Retour au numéro
Article précédent
- Discordance d’expression du récepteur du facteur de croissance épidermique de type 2 (HER2) et des récepteurs hormonaux entre les lésions primitives de cancer du sein et leurs métastases cérébrales
- C. Joubert, S. Boissonneau, R. Faguer, F. Fina, T. Adetchessi, S. Fuentes, H. Dufour, P. Metellus
- Syndrome d’hyperactivité de noyaux du tronc cérébral par conflit vasculaire apparemment intra-axial traité par décompression vasculaire microchirurgicale (avec vidéo présentation)
- T. Idriceanu, M. Sindou, C. Vial
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?