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5. Clinical parameters for predicting radiation-induced liver disease after intrahepatic reirradiation for hepatocellular carcinoma.

Author

Yaoru Huang, Shang-Wen Chen, Ching-Chao Fan, Lai-Lei Ting, Chia-Chun Kuo, Jeng-Fong Chiou, Huang, Yaoru, Chen, Shang-Wen, Fan, Ching-Chao, Ting, Lai-Lei, Kuo, Chia-Chun, and Chiou, Jeng-Fong

Subjects
LIVER cancer, CHEMOEMBOLIZATION, IRRADIATION, RADIOTHERAPY, PATIENT compliance, THERAPEUTICS, PROGNOSIS, CANCER relapse, HEPATOCELLULAR carcinoma, LIVER, LIVER tumors, RADIATION measurements, RADIATION injuries, PROPORTIONAL hazards models, RETROSPECTIVE studies, KAPLAN-Meier estimator
Abstract

Background: Few data are available on the tolerance of reirradiation in patients with hepatocellular carcinoma (HCC). This study determined the clinical parameters contributing to the development of radiation-induced liver disease (RILD).Methods: We included 36 patients with HCC who received 2 courses of radiotherapy (RT) to the liver. Using α/β = 15 for tumor and α/β =8 for normal liver tissue for biologically equivalent doses in 2 Gy fractions, mean cumulative to the hepatic tumor and normal liver were 87.7 Gy15 and 31.1 Gy8, respectively. Hepatic toxicities were classified according to the Common Terminology Criteria for Adverse Events, Version 4.0. Clinical data, including liver function test results, radiological study findings, and RT parameters before and after both courses of RT were retrieved for analysis. Using multivariate analysis, logistic regression was used to identify the predictors of RILD, and Cox regression was performed to explore the prognostic factors for overall survival (OS).Results: Thirteen patients (36 %) developed RILD after reirradiation. Nine of them died because of progressive liver failure without evidence of tumor progression and were categorized to have lethal RILD. A pretreatment Child-Turcotte-Pugh (CTP) score ≥6 was the only predictor of RILD [odds ratio (OR): 15.83, p = 0.001] and lethal RILD [OR: 72.56, p = 0.005]. In addition, a CTP score ≥6 and the presence of portal vein tumor thrombosis before reirradiation were 2 prognostic factors for OS.Conclusion: Despite a limited sample size, residual liver function using a preirradiation CTP score ≥6 is a clinical parameter associated with an increased risk of RILD in patients requiring hepatic reirradiation. [ABSTRACT FROM AUTHOR]

Published
2016
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6. 5th International Symposium on Focused Ultrasound: North Bethesda, MD, USA. 28 August- 1 September 2016

Author

Zaaroor, Menashe, Sinai, Alon, Goldsher, Dorit, Eran, Ayelet, Nassar, Maria, Schlesinger, Ilana, Parker, Jonathon, Ravikumar, Vinod, Ghanouni, Pejman, Stein, Sherman, Halpern, Casey, Krishna, Vibhor, Hargrove, Amelia, Agrawal, Punit, Changizi, Barbara, Bourekas, Eric, Knopp, Michael, Rezai, Ali, Mead, Brian, Kim, Namho, Mastorakos, Panagiotis, Suk, Jung Soo, Miller, Wilson, Klibanov, Alexander, Hanes, Justin, Price, Richard, Wang, Shutao, Olumolade, Oluyemi, Kugelman, Tara, Jackson-Lewis, Vernice, Karakatsani, Maria Eleni (Marilena), Han, Yang, Przedborski, Serge, Konofagou, Elisa, Hynynen, Kullervo, Aubert, Isabelle, Leinenga, Gerhard, Nisbet, Rebecca, Hatch, Robert, Van der Jeugd, Anneke, Evans, Harrison, Götz, Jürgen, Van der Jeugd, Ann, Fishman, Paul, Yarowsky, Paul, Frenkel, Victor, Wei-Bin, Shen, Nguyen, Ben, Sanchez, Carlos Sierra, Acosta, Camilo, Chen, Cherry, Wu, Shih-Ying, Aryal, Muna, Papademetriou, Iason T., Zhang, Yong-Zhi, Power, Chanikarn, McDannold, Nathan, Porter, Tyrone, Kovacs, Zsofia, Kim, Saejeong, Jikaria, Neekita, Qureshi, Farhan, Bresler, Michele, Frank, Joseph, Odéen, Henrik, Chiou, George, Snell, John, Todd, Nick, Madore, Bruno, Parker, Dennis, Pauly, Kim Butts, Marx, Mike, Jonathan, Sumeeth, Grissom, William, Arvanitis, Costas, Clement, Gregory, de Bever, Joshua, Payne, Allison, Christensen, Douglas, Maimbourg, Guillaume, Santin, Mathieu David, Houdouin, Alexandre, Lehericy, Stéphane, Tanter, Mickael, Aubry, Jean Francois, Federau, Christian, Werner, Beat, Paeng, Dong-Guk, Xu, Zhiyuan, Quigg, Anders, Eames, Matt, Jin, Changzhu, Everstine, Ashli, Sheehan, Jason, Lopes, M. Beatriz, Kassell, Neal, Drake, James, Price, Karl, Lustgarten, Lior, Sin, Vivian, Mougenot, Charles, Donner, Elizabeth, Tam, Emily, Hodaie, Mojgan, Waspe, Adam, Looi, Thomas, Pichardo, Samuel, Lee, Wonhye, Chung, Yong An, Jung, Yujin, Song, In-Uk, Yoo, Seung-Schik, Kim, Hyun-Chul, Lee, Jong-Hwan, Caskey, Charles, Zinke, Wolf, Cosman, Josh, Shuman, Jillian, Schall, Jeffrey, Aurup, Christian, Chen, Hong, Kamimura, Hermes, Carneiro, Antonio, Sun, Tao, Nazai, Navid, Patz, Sam, Livingstone, Margaret, Mainprize, Todd, Huang, Yuexi, Alkins, Ryan, Chapman, Martin, Perry, James, Lipsman, Nir, Bethune, Allison, Sahgal, Arjun, Trudeau, Maureen, Liu, Hao-Li, Hsu, Po-Hung, Wei, Kuo-Chen, Sutton, Jonathan, Alexander, Phillip, Miller, Eric, Kobus, Thiele, Carpentier, Alexandre, Canney, Michael, Vignot, Alexandre, Beccaria, Kevin, Leclercq, Delphine, Lafon, Cyril, Chapelon, Jean Yves, Hoang-Xuan, Khe, Delattre, Jean-Yves, Idbaih, Ahmed, Moore, David, Xu, Alexis, Schmitt, Paul, Foley, Jessica, Sukovich, Jonathan, Cain, Charles, Pandey, Aditya, Chaudhary, Neeraj, Camelo-Piragua, Sandra, Allen, Steven, Cannata, Jon, Teofilovic, Dejan, Bertolina, Jim, Hall, Timothy, Xu, Zhen, Grondin, Julien, Ferrera, Vincent, ter Haar, Gail, Mouratidis, Petros, Repasky, Elizabeth, Timbie, Kelsie, Badr, Lena, Campbell, Benjamin, McMichael, John, Buckner, Andrew, Prince, Jessica, Stevens, Aaron, Bullock, Timothy, Skalina, Karin, Guha, Chandan, Orsi, Franco, Bonomo, Guido, Vigna, Paolo Della, Mauri, Giovanni, Varano, Gianluca, Schade, George, Wang, Yak-Nam, Pillarisetty, Venu, Hwang, Joo Ha, Khokhlova, Vera, Bailey, Michael, Khokhlova, Tatiana, Sinilshchikov, Ilya, Yuldashev, Petr, Andriyakhina, Yulia, Kreider, Wayne, Maxwell, Adam, Sapozhnikov, Oleg, Partanen, Ari, Lundt, Jonathan, Preusser, Tobias, Haase, Sabrina, Bezzi, Mario, Jenne, Jürgen, Langø, Thomas, Midiri, Massimo, Mueller, Michael, Sat, Giora, Tanner, Christine, Zangos, Stephan, Guenther, Matthias, Melzer, Andreas, Menciassi, Arianna, Tognarelli, Selene, Cafarelli, Andrea, Diodato, Alessandro, Ciuti, Gastone, Rothluebbers, Sven, Schwaab, Julia, Strehlow, Jan, Mihcin, Senay, Tretbar, Steffen, Payen, Thomas, Palermo, Carmine, Sastra, Steve, Olive, Kenneth, Adams, Matthew, Salgaonkar, Vasant, Scott, Serena, Sommer, Graham, Diederich, Chris, Vidal-Jove, Joan, Perich, Eloi, Ruiz, Antonio, Velat, Manuela, Melodelima, David, Dupre, Aurelien, Vincenot, Jeremy, Yao, Chen, Perol, David, Rivoire, Michel, Tucci, Samantha, Mahakian, Lisa, Fite, Brett, Ingham, Elizabeth, Tam, Sarah, Hwang, Chang-il, Tuveson, David, Ferrara, Katherine, Scionti, Stephen, Chen, Lili, Cvetkovic, Dusica, Chen, Xiaoming, Gupta, Roohi, Wang, Bin, Ma, Charlie, Bader, Kenneth, Haworth, Kevin, Holland, Christy, Sanghvi, Narendra, Carlson, Roy, Chen, Wohsing, Chaussy, Christian, Thueroff, Stefan, Cesana, Claudio, Bellorofonte, Carlo, Wang, Qingguo, Wang, Han, Wang, Shengping, Zhang, Junhai, Bazzocchi, Alberto, Napoli, Alessandro, Staruch, Robert, Bing, Chenchen, Shaikh, Sumbul, Nofiele, Joris, Szczepanski, Debra, Staruch, Michelle Wodzak, Williams, Noelle, Laetsch, Theodore, Chopra, Rajiv, Rosenberg, Jarrett, Bitton, Rachelle, LeBlang, Suzanne, Meyer, Joshua, Hurwitz, Mark, Yarmolenko, Pavel, Celik, Haydar, Eranki, Avinash, Beskin, Viktoriya, Santos, Domiciano, Patel, Janish, Oetgen, Matthew, Kim, AeRang, Kim, Peter, Sharma, Karun, Chisholm, Alexander, Aleman, Dionne, Scipione, Roberto, Temple, Michael, Amaral, Joao Guilherme, Endre, Ruby, Lamberti-Pasculli, Maria, de Ruiter, Joost, Campbell, Fiona, Stimec, Jennifer, Gupta, Samit, Singh, Manoj, Hopyan, Sevan, Czarnota, Gregory, Brenin, David, Rochman, Carrie, Kovatcheva, Roussanka, Vlahov, Jordan, Zaletel, Katja, Stoinov, Julian, Bucknor, Matthew, Rieke, Viola, Shim, Jenny, Koral, Korgun, Lang, Brian, Wong, Carlos, Lam, Heather, Shinkov, Alexander, Hu, Jim, Zhang, Xi, Macoskey, Jonathan, Ives, Kimberly, Owens, Gabe, Gurm, Hitinder, Shi, Jiaqi, Pizzuto, Matthew, Dillon, Christopher, Christofferson, Ivy, Hilas, Elaine, Shea, Jill, Greillier, Paul, Ankou, Bénédicte, Bessière, Francis, Zorgani, Ali, Pioche, Mathieu, Kwiecinski, Wojciech, Magat, Julie, Melot-Dusseau, Sandrine, Lacoste, Romain, Quesson, Bruno, Pernot, Mathieu, Catheline, Stefan, Chevalier, Philippe, Marquet, Fabrice, Bour, Pierre, Vaillant, Fanny, Amraoui, Sana, Dubois, Rémi, Ritter, Philippe, Haïssaguerre, Michel, Hocini, Mélèze, Bernus, Olivier, Tebebi, Pamela, Burks, Scott, Milo, Blerta, Gertner, Michael, Zhang, Jimin, Wong, Andrew, Liu, Yu, Kheirolomoom, Azadeh, Seo, Jai, Watson, Katherine, Zhang, Hua, Foiret, Josquin, Borowsky, Alexander, Xu, Doudou, Thanou, Maya, Centelles, Miguell, Wright, Mike, Amrahli, Maral, So, Po-Wah, Gedroyc, Wladyslaw, Kneepkens, Esther, Heijman, Edwin, Keupp, Jochen, Weiss, Steffen, Nicolay, Klaas, Grüll, Holger, Nagle, Matthew, Nikolaeva, Anastasia V., Terzi, Marina E., Tsysar, Sergey A., Cunitz, Bryan, Mourad, Pierre, Downs, Matthew, Yang, Georgiana, Wang, Qi, Chen, Johnny, Farry, Justin, Dixon, Adam, Du, Zhongmin, Dhanaliwala, Ali, Hossack, John, Ranjan, Ashish, Maples, Danny, Wardlow, Rachel, Malayer, Jerry, Ramachandran, Akhilesh, Namba, Hirofumi, Kawasaki, Motohiro, Izumi, Masashi, Kiyasu, Katsuhito, Takemasa, Ryuichi, Ikeuchi, Masahiko, Ushida, Takahiro, Crake, Calum, Kothapalli, Satya V. V. N., Leighton, Wan, Wang, Zhaorui, Gach, H. Michael, Straube, William, Altman, Michael, Kim, Young-sun, Lim, Hyo Keun, Rhim, Hyunchul, van Breugel, Johanna, Braat, Manon, Moonen, Chrit, van den Bosch, Maurice, Ries, Mario, Marrocchio, Cristina, Dababou, Susan, Lee, Jae Young, Chung, Hyun Hoon, Kang, Soo Yeon, Kang, Kook Jin, Son, Keon Ho, Zhang, Dandan, Plata, Juan, Jones, Peter, Pascal-Tenorio, Aurea, Bouley, Donna, Bond, Aaron, Dallapiazza, Robert, Huss, Diane, Warren, Amy, Sperling, Scott, Gwinn, Ryder, Shah, Binit, Elias, W. Jeff, Curley, Colleen, Zhang, Ying, Negron, Karina, Abounader, Roger, Samiotaki, Gesthimani, Tu, Tsang-Wei, Papadakis, Georgios, Hammoud, Dima, Silvestrini, Matthew, Wolfram, Frank, Güllmar, Daniel, Reichenbach, Juergen, Hofmann, Denis, Böttcher, Joachim, Schubert, Harald, Lesser, Thomas G., Almquist, Scott, Camarena, Francisco, Jiménez-Gambín, Sergio, Jiménez, Noé, Chang, Jin Woo, Chaplin, Vandiver, Griesenauer, Rebekah, Miga, Michael, Ellens, Nicholas, Airan, Raag, Quinones-Hinojosa, Alfredo, Farahani, Keyvan, Feng, Xue, Fielden, Samuel, Zhao, Li, Wintermark, Max, Meyer, Craig, Guo, Sijia, Lu, Xin, Zhuo, Jiachen, Xu, Su, Gullapalli, Rao, Gandhi, Dheeraj, Brokman, Omer, Baek, Hongchae, Kim, Hyungmin, Leung, Steven, Webb, Taylor, Vykhodtseva, Natalia, Nguyen, Thai-Son, Park, Chang Kyu, Park, Sang Man, Jung, Na Young, Kim, Min Soo, Chang, Won Seok, Jung, Hyun Ho, Plaksin, Michael, Weissler, Yoni, Shoham, Shy, Kimmel, Eitan, Rosnitskiy, Pavel B., Krupa, Steve, Hazan, Eilon, Naor, Omer, Levy, Yoav, Maimon, Noam, Brosh, Inbar, Kahn, Itamar, Cahill, Jessica, Colas, Elodie Constanciel, Wydra, Adrian, Maev, Roman, Aly, Amirah, Sesenoglu-Laird, Ozge, Padegimas, Linas, Cooper, Mark, Waszczak, Barbara, Tehrani, Seruz, Slingluff, Craig, Larner, James, Andarawewa, Kumari, Ozhinsky, Eugene, Shah, Rutwik, Krug, Roland, Deckers, Roel, Linn, Sabine, Suelmann, Britt, Witkamp, Arjen, Vaessen, Paul, van Diest, Paul, Bartels, Lambertus W., Bos, Clemens, Borys, Nicolas, Storm, Gert, Van der Wall, Elsken, Farr, Navid, Alnazeer, Moez, Katti, Prateek, Wood, Bradford, Farrer, Alexis, Ferrer, Cyril, de Senneville, Baudouin Denis, van Stralen, Marijn, Liu, Jingfei, Leach, J. Kent, Zidowitz, Stephan, Lee, Hsin-Lun, Hsu, Fang-Chi, Kuo, Chia-Chun, Jeng, Shiu-Chen, Chen, Tung-Ho, Yang, Nai-Yi, Chiou, Jeng-Fong, Kao, Yi-tzu, Pan, Chia-Hsin, Wu, Jing-Fu, Tsai, Yi-Chieh, Johnson, Sara, Li, Dawei, He, Ye, Karakitsios, Ioannis, Schwenke, Michael, Demedts, Daniel, Xiao, Xu, Cavin, Ian, Minalga, Emilee, Merrill, Robb, Hadley, Rock, Ramaekers, Pascal, de Greef, Martijn, Shahriari, Kian, Parvizi, Mohammad Hossein, Asadnia, Kiana, Chamanara, Marzieh, Kamrava, Seyed Kamran, Chabok, Hamid Reza, Stein, Ruben, Muller, Sébastien, Tan, Jeremy, Zachiu, Cornel, Erasmus, Hans-Peter, Van Arsdell, Glen, Benson, Lee, Jang, Kee W., Angstadt, Mary, Lewis, Bobbi, McLean, Hailey, Hoogenboom, Martijn, Eikelenboom, Dylan, den Brok, Martijn, Wesseling, Pieter, Heerschap, Arend, Fütterer, Jurgen, Adema, Gosse, Wang, Kevin, Zhong, Pei, Joy, Joyce, McLeod, Helen, Kim, Harry, Lewis, Matthew, Ozilgen, Arda, Zahos, Peter, Coughlin, Dezba, Tang, Xinyan, Lotz, Jeff, Jedruszczuk, Kathleen, Gulati, Amitabh, Solomon, Stephen, Kaye, Elena, Mugler, John, Barbato, Gaetano, Scoarughi, Gian Luca, Corso, Cristiano, Gorgone, Alessandro, Migliore, Ilaria Giuseppina, Larrabee, Zachary, Hananel, Arik, Aubry, Jean-Francois, Negussie, Ayele, Wilson, Emmanuel, Seifabadi, Reza, Moon, Hyungwon, Kang, Jeeun, Sim, Changbeom, Chang, Jin Ho, Kim, Hyuncheol, Lee, Hak Jong, Sasaki, Noboru, Takiguchi, Mitsuyoshi, Sebeke, Lukas, Luo, Xi, de Jager, Bram, Heemels, Maurice, Abraham, Christopher, Curiel, Laura, Berriet, Rémi, Janát-Amsbury, Margit, Corea, Joseph, Ye, Patrick Peiyong, Arias, Ana Clauda, Lustig, Micheal, and Svedin, Bryant

Published
2016
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7. EGFR mutations are associated with favorable intracranial response and progression-free survival following brain irradiation in non-small cell lung cancer patients with brain metastases.

Author

Hsin-Lun Lee, Tao-Sang Chung, Lai-Lei Ting, Jo-Ting Tsai, Shang-Wen Chen, Jeng-Fong Chiou, Henry Wing-Cheung Leung, H Eugene Liu, Lee, Hsin-Lun, Chung, Tao-Sang, Ting, Lai-Lei, Tsai, Jo-Ting, Chen, Shang-Wen, Chiou, Jeng-Fong, Leung, Henry Wing-Cheung, and Liu, H Eugene

Subjects
GENETIC mutation, EPIDERMAL growth factor receptors, LUNG cancer, METASTASIS, REGRESSION analysis
Abstract

Background: The presence of epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) is associated with increased radiosensitivity in vitro. However, the results from clinical studies regarding the radiosensitivity in NSCLC with mutant EGFR are inconclusive. We retrospectively analyzed our NSCLC patients who had been regularly followed up by imaging studies after irradiation for brain metastases, and investigated the impact of EGFR mutations on radiotherapy (RT).Methods: Forty-three patients with brain metastases treated with RT, together with EGFR mutation status, demographics, smoking history, performance status, recursive partitioning analysis (RPA) class, tumor characteristics, and treatment modalities, were included. Radiological images were taken at 1 to 3 months after RT, and 3 to 6 months thereafter. Radiographic response was evaluated by RECIST criteria version 1.1 according to the intracranial images before and after RT. Log-rank test and Cox regression model were used to correlate EGFR mutation status and other clinical features with intracranial radiological progression-free survival (RPFS) and overall survival (OS).Results: The median follow-up duration was 15 months. Patients with mutant EGFR had higher response rates to brain RT than those with wild-type EGFR (80% vs. 46%; p = 0.037). Logistic regression analysis showed that EGFR mutation status is the only predictor for treatment response (p = 0.032). The median intracranial RPFS was 18 months (95% CI = 8.33-27.68 months). In Cox regression analysis, mutant EGFR (p = 0.025) and lower RPA class (p = 0.026) were associated with longer intracranial RPFS. EGFR mutation status (p = 0.061) and performance status (p = 0.076) had a trend to predict OS.Conclusions: Mutant EGFR in NSCLC patients is an independent prognostic factor for better treatment response and longer intracranial RPFS following RT for brain metastases. [ABSTRACT FROM AUTHOR]

Published
2012
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8. Clinical parameters for predicting radiation-induced liver disease after intrahepatic reirradiation for hepatocellular carcinoma.

Author

Huang Y, Chen SW, Fan CC, Ting LL, Kuo CC, and Chiou JF

Subjects
Adult, Aged, Aged, 80 and over, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Prognosis, Proportional Hazards Models, Radiometry, Retrospective Studies, Risk Factors, Carcinoma, Hepatocellular radiotherapy, Liver radiation effects, Liver Neoplasms radiotherapy, Neoplasm Recurrence, Local radiotherapy, Radiation Injuries epidemiology, Re-Irradiation adverse effects
Abstract

Background: Few data are available on the tolerance of reirradiation in patients with hepatocellular carcinoma (HCC). This study determined the clinical parameters contributing to the development of radiation-induced liver disease (RILD)., Methods: We included 36 patients with HCC who received 2 courses of radiotherapy (RT) to the liver. Using α/β = 15 for tumor and α/β =8 for normal liver tissue for biologically equivalent doses in 2 Gy fractions, mean cumulative to the hepatic tumor and normal liver were 87.7 Gy15 and 31.1 Gy8, respectively. Hepatic toxicities were classified according to the Common Terminology Criteria for Adverse Events, Version 4.0. Clinical data, including liver function test results, radiological study findings, and RT parameters before and after both courses of RT were retrieved for analysis. Using multivariate analysis, logistic regression was used to identify the predictors of RILD, and Cox regression was performed to explore the prognostic factors for overall survival (OS)., Results: Thirteen patients (36 %) developed RILD after reirradiation. Nine of them died because of progressive liver failure without evidence of tumor progression and were categorized to have lethal RILD. A pretreatment Child-Turcotte-Pugh (CTP) score ≥6 was the only predictor of RILD [odds ratio (OR): 15.83, p = 0.001] and lethal RILD [OR: 72.56, p = 0.005]. In addition, a CTP score ≥6 and the presence of portal vein tumor thrombosis before reirradiation were 2 prognostic factors for OS., Conclusion: Despite a limited sample size, residual liver function using a preirradiation CTP score ≥6 is a clinical parameter associated with an increased risk of RILD in patients requiring hepatic reirradiation.

Published
2016
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9. EGFR mutations are associated with favorable intracranial response and progression-free survival following brain irradiation in non-small cell lung cancer patients with brain metastases.

Author

Lee HL, Chung TS, Ting LL, Tsai JT, Chen SW, Chiou JF, Leung HW, and Liu HE

Subjects
Adult, Aged, Aged, 80 and over, Brain Neoplasms genetics, Brain Neoplasms mortality, Brain Neoplasms secondary, Carcinoma, Non-Small-Cell Lung genetics, Carcinoma, Non-Small-Cell Lung mortality, Carcinoma, Non-Small-Cell Lung pathology, Female, Follow-Up Studies, Humans, Lung Neoplasms genetics, Lung Neoplasms mortality, Lung Neoplasms pathology, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Rate, Brain Neoplasms radiotherapy, Carcinoma, Non-Small-Cell Lung radiotherapy, Cranial Irradiation, ErbB Receptors genetics, Lung Neoplasms radiotherapy, Mutation genetics
Abstract

Background: The presence of epidermal growth factor receptor (EGFR) mutations in non-small cell lung cancer (NSCLC) is associated with increased radiosensitivity in vitro. However, the results from clinical studies regarding the radiosensitivity in NSCLC with mutant EGFR are inconclusive. We retrospectively analyzed our NSCLC patients who had been regularly followed up by imaging studies after irradiation for brain metastases, and investigated the impact of EGFR mutations on radiotherapy (RT)., Methods: Forty-three patients with brain metastases treated with RT, together with EGFR mutation status, demographics, smoking history, performance status, recursive partitioning analysis (RPA) class, tumor characteristics, and treatment modalities, were included. Radiological images were taken at 1 to 3 months after RT, and 3 to 6 months thereafter. Radiographic response was evaluated by RECIST criteria version 1.1 according to the intracranial images before and after RT. Log-rank test and Cox regression model were used to correlate EGFR mutation status and other clinical features with intracranial radiological progression-free survival (RPFS) and overall survival (OS)., Results: The median follow-up duration was 15 months. Patients with mutant EGFR had higher response rates to brain RT than those with wild-type EGFR (80% vs. 46%; p = 0.037). Logistic regression analysis showed that EGFR mutation status is the only predictor for treatment response (p = 0.032). The median intracranial RPFS was 18 months (95% CI = 8.33-27.68 months). In Cox regression analysis, mutant EGFR (p = 0.025) and lower RPA class (p = 0.026) were associated with longer intracranial RPFS. EGFR mutation status (p = 0.061) and performance status (p = 0.076) had a trend to predict OS., Conclusions: Mutant EGFR in NSCLC patients is an independent prognostic factor for better treatment response and longer intracranial RPFS following RT for brain metastases.

Published
2012
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