Affiliation:
1. Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical Sciences
2. The First Affiliated Hospital of Shantou University Medical College
3. Shandong Cancer Hospital, Shandong University
4. Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital)
Abstract
Abstract
Background
Consider the impact of life expectancy for timing of treatment intervention, this retrospective study aimed to evaluate whether predicting timing of cranial radiotherapy (CRT) in NSCLC patients with BM through lung-molGPA index.
Methods
The lung-molGPA scores were obtained and used as a basis to stratify the patients. The effect of radiotherapy timing on survival time in groups stratified by lung-molGPA index was evaluated. Upfront CRT was defined as CRT received within 3 months after initial diagnosis of BM and no progression of BM prior to CRT. While deferred CRT was receiving CRT after progression of BM or initial diagnosis of BM three months later.
Results
In the entire cohort, the median OS and PFS were 17.0 and 9.2 months, respectively. In the lung-molGPA2.5–4 group, the addition of CRT prolonged the OS and PFS of patients (OS = HR: 0.66, 95% CI: 0.48–0.91, P < .001; and PFS = HR: 0.74, 95% CI: 0.54–1.01, P = .001). Moreover, in patients with lung-molGPA score of 2.5–4, the median OS times of the upfront CRT and deferred CRT groups were 26.0 months and 18.0 months, respectively; meanwhile, the OS of the upfront CRT group was significantly superior to that of the deferred CRT group (HR: 0.69, 95% CI: 0.42–1.13, P = .002).
Conclusion
In patients who obtained a lung-molGPA score of 2.5–4.0, upfront CRT could benefit patients’ survival. In patients who obtained a score of 0–2, the survival benefit from CRT was limited.
Publisher
Research Square Platform LLC