Prospective Study of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors Concurrent With Individualized Radiotherapy for Patients With Locally Advanced or Metastatic Non–Small-Cell Lung Cancer

Wang, Jing; Xia, Tingyi; Wang, Yingjie; Li, Hongqi; Li, Ping; Wang, Jidong; Chang, Dongshu; Liu, Liy-Yuan; Di, Y.; Wang, Xuan; Wu, W J

doi:10.1016/j.ijrobp.2010.12.035

Cited by 56 publications

(45 citation statements)

References 41 publications

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“…Both radiation-induced pulmonary pneumonitis and lung fibrosis were also noticed in 15% and 6% of the patients respectively, with no grade 3 or 4 toxicity. Skin rashes, diarrhoea and haematological toxicities were less while late complications like radiation-induced pneumonitis and lung fibrosis were more in present study as compared to study by Wang et al 5 Difference in rate of complications was due to use of conventional fraction and curative intent of treatment by Wang et al 14 On CECT chest, sixty eight percent patients had shown partial response to the treatment while 32% patients had maintained stable disease status at first follow up. Not even a single patient had shown progressive disease nor any patient died in 1 month following the treatment.…”

contrasting

confidence: 46%

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Verma¹

2017

jmscr

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contrasting

confidence: 46%

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Verma¹

2017

jmscr

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“…Therefore, this study provides new insights for the field. Further, some previous studies showed that fewer cases of radiation pneumonitis occurred in patients treated with a combination of erlotinib and thoracic radiotherapy 22. Additionally, some previous studies showed that a high incidence of radiation pneumonitis occurred during this treatment,20,21 but all samples from the different studies were small and the results clearly need to be confirmed by further research.…”

Section: Discussionmentioning

confidence: 91%

Preliminary analysis of the risk factors for radiation pneumonitis in patients with non- small-cell lung cancer treated with concurrent erlotinib and thoracic radiotherapy

Zhuang¹,

Hou²,

Wang³

et al. 2014

OTT

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PurposeThe aim of this study was to investigate radiation pneumonitis and its associated risk factors in patients with non-small-cell lung cancer treated with concurrent erlotinib and thoracic radiotherapy.Materials and methodsWe conducted an analysis of patients with nonoperable stage IIIA–IV non-small-cell lung cancer who were treated with concurrent thoracic radiotherapy and erlotinib (ClinicalTrials.gov identifier: NCT00973310). The Common Terminology Criteria for Adverse Events version 3.0 grading system was applied to evaluate the incidence of radiation pneumonitis. The lung dosimetric parameters were recorded in accordance with the treatment plan, and the study endpoint was radiation pneumonitis at grade 2 or more.ResultsAmong the 24 selected clinical cases, nine were identified with radiation pneumonitis of grade 2 or above (37.5%). This included four cases with grade 2 (16.7%), two cases with grade 3 (8.3%), and three cases with grade 5 (12.5%). The results showed that the planning target volume was a significant factor affecting the incidence of radiation pneumonitis. All lung dosimetric parameters exhibited statistically significant differences between patients with pneumonitis and patients without pneumonitis. The receiver operating characteristic (ROC) curve analysis showed that all lung dosimetric parameters were useful in predicting the incidence of radiation pneumonitis. In addition, the threshold values of V5, V10, V15, V20, V30, and mean lung dose were >44%, >29%, >27%, >22%, >17% and >1,027 cGy, respectively.ConclusionSpecial attention should be paid to the adverse effects of radiation pneumonitis in concurrent thoracic radiotherapy and erlotinib treatment. Lung dosimetric parameters are important predictive factors in radiation pneumonitis.

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“…These encouraging results indicated that radiotherapy might aid expansion the effectiveness of TKI therapy in those patients who are responding to TKI treatment. In another two studies using TKI combined with radiotherapy in stage III/ IV NSCLC, although enrolled patients was not selected based on the EGFR mutation status, the median PFS of 10-14 months and survival time of 20-22 months were observed with acceptable toxicities, indicated the feasibility of targeted therapy combined with advanced radiotherapy in clinical practice (33,34). Recently, we launched a phase II trial of hypofractionated radiotherapy for limited metastatic NSCLC harboring sensitizing EGFR mutations, the inclusion patients are required to be oligometastatic disease (≤5 discrete lesions of disease, exclusive of the brain metastases) after 3 months of TKI therapy, evaluated by PET/CT scan.…”

Section: Early Intervention Of Radiotherapy In Tki Therapymentioning

confidence: 99%

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

Xia

Zhang

2017

J. Thorac. Dis.

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In recent years, the treatment of advanced non-small cell lung cancer (NSCLC) was greatly promoted by the discovery of oncogenic drivers and the development of targeted therapies specific for these drivers. Somatic mutations in epidermal growth factor receptor (EGFR) are the most common type in patients with NSCLC. Small-molecule tyrosine kinase inhibitor (TKI) targeting EGFR produced relatively high response rate and long duration with acceptable toxicity profile. Also, the life expectancy in patients with active EGFR mutation has been significantly prolonged than the past. Additionally, evolution of advanced imaging and radiation techniques has expanded the indications for radiotherapy in complex clinical situation. All of those factors contributed to the widely use of radiotherapy for advanced NSCLC treated with TKI therapy. In this review, we will discuss how to integrate radiotherapy into the comprehensive treatment of patients with TKI therapy in order to maximize the therapeutics effect.

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Prospective Study of Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors Concurrent With Individualized Radiotherapy for Patients With Locally Advanced or Metastatic Non–Small-Cell Lung Cancer

Cited by 56 publications

References 41 publications

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Palliative Radiotherapy with Concomitant and Maintenance Gefitinib for the Management of Locally Advanced Adenocarcinoma Lung Patients Unfit For Radical Treatment

Preliminary analysis of the risk factors for radiation pneumonitis in patients with non- small-cell lung cancer treated with concurrent erlotinib and thoracic radiotherapy

Management of non-small cell lung cancer with EGFR mutation: the role of radiotherapy in the era of tyrosine kinase inhibitor therapy—opportunities and challenges

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