Treatment Patterns and Survival Outcomes of Non-Small Cell Lung Cancer Patients Initially Diagnosed With Brain Metastases in Real-World Clinical Practice
Background This study aimed to comprehensively analyze the characteristics, treatment patterns, and survival outcomes of non-small-cell lung cancer (NSCLC) patients initially diagnosed with brain metastases (BMs) in real-world practice. Methods We enrolled NSCLC patients initially diagnosed with BMs...
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| Veröffentlicht in: | Frontiers in oncology 2020-10, Vol.10, p.581729-581729, Article 581729 |
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| creator | Chen, Xin-Ru Hou, Xue Dinglin, Xiao-Xiao Liu, Yong-Dong Li, Yin Zheng, Wei Li, De-Lan Chen, Jing Wu, Xiao-Liang Wang, Kai-Cheng Ma, Shu-Xiang Zeng, Yin-Duo Chen, Li-Kun |
| description | Background This study aimed to comprehensively analyze the characteristics, treatment patterns, and survival outcomes of non-small-cell lung cancer (NSCLC) patients initially diagnosed with brain metastases (BMs) in real-world practice. Methods We enrolled NSCLC patients initially diagnosed with BMs between Jan 2004 and Jan 2018 in our institution. Patient demographics, treatment modalities, and survival outcomes were then analyzed. Brain localized treatment (BLT) included early brain radiotherapy (EBR), deferred brain radiotherapy (DBR), and surgery. Results A total of 954 patients were identified. Concerning initial treatment, 525 patients (55.0%) received systemic medication (SM)+BLT, 400 patients (41.9%) received SM only, and 29 patients received BLT only (3.0%). SM+BLT cohort was associated with longer median overall survival (mOS) than the SM only and the BLT only cohorts both in epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK)-negative/unknown patients (15.3 months, 95% confidence interval [CI], 14.2-16.4; 11.1 months, 9.0-13.2; 7.0 months, 5.4-8.6; p |
| doi_str_mv | 10.3389/fonc.2020.581729 |
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| fullrecord | <record><control><sourceid>proquest_webof</sourceid><recordid>TN_cdi_webofscience_primary_000581048500001CitationCount</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_590703adb1334ba3a86b2833ac069d4a</doaj_id><sourcerecordid>2458965845</sourcerecordid><originalsourceid>FETCH-LOGICAL-c462t-98c807668dbb373e6870cbc64945f5cb5a04b58bed3c0034386f0667f92f80163</originalsourceid><addsrcrecordid>eNqNUstu1DAUjRCIVqV7VshLJJTBiR9xNkgQXiMNtKJFZWfdOM7UVWK3tjOon8Lf4jRl1O6wLD_POffq3pNlLwu8IkTUb3tn1arEJV4xUVRl_SQ7LEtC85qSX08fnA-y4xCucBqc4QKT59kBIQUntMCH2Z9zryGO2kZ0CjFqbwMC26Gzye_MDgZ0MkXlRh2Q69F3Z_OzEYYBNTotm8luUQNWaT-TTRIJaG1NNAlyiz4a2FoXdIcuTLxEHzwYi77pCCHNJJhuPzQM-YXzQ4eawVijUsBTDyoapV9kz3oYgj6-34-yn58_nTdf883Jl3XzfpMrysuY10IJXHEuurYlFdFcVFi1itOasp6plgGmLROt7ojCmFAieI85r_q67AVOZTjK1otu5-BKXnszgr-VDoy8e3B-K8GnhAYtWY0rTKBrC0JoCwQEb0tBCCjM645C0nq3aF1P7ag7lSriYXgk-vjHmku5dTtZ3bVwTub1vYB3N5MOUY4mqFRssNpNQZaUiZozQVmC4gWqvAvB634fpsByNoicDSJng8jFIIny6mF6e8I_OySAWAC_dev6oFJLld7DkoOSEKaCzWYqGhNT051t3GRjor75fyr5Cx4s2ZM</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2458965845</pqid></control><display><type>article</type><title>Treatment Patterns and Survival Outcomes of Non-Small Cell Lung Cancer Patients Initially Diagnosed With Brain Metastases in Real-World Clinical Practice</title><source>DOAJ Directory of Open Access Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central Open Access</source><source>Web of Science - Science Citation Index Expanded - 2020<img src="https://exlibris-pub.s3.amazonaws.com/fromwos-v2.jpg" /></source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Chen, Xin-Ru ; Hou, Xue ; Dinglin, Xiao-Xiao ; Liu, Yong-Dong ; Li, Yin ; Zheng, Wei ; Li, De-Lan ; Chen, Jing ; Wu, Xiao-Liang ; Wang, Kai-Cheng ; Ma, Shu-Xiang ; Zeng, Yin-Duo ; Chen, Li-Kun</creator><creatorcontrib>Chen, Xin-Ru ; Hou, Xue ; Dinglin, Xiao-Xiao ; Liu, Yong-Dong ; Li, Yin ; Zheng, Wei ; Li, De-Lan ; Chen, Jing ; Wu, Xiao-Liang ; Wang, Kai-Cheng ; Ma, Shu-Xiang ; Zeng, Yin-Duo ; Chen, Li-Kun</creatorcontrib><description>Background This study aimed to comprehensively analyze the characteristics, treatment patterns, and survival outcomes of non-small-cell lung cancer (NSCLC) patients initially diagnosed with brain metastases (BMs) in real-world practice. Methods We enrolled NSCLC patients initially diagnosed with BMs between Jan 2004 and Jan 2018 in our institution. Patient demographics, treatment modalities, and survival outcomes were then analyzed. Brain localized treatment (BLT) included early brain radiotherapy (EBR), deferred brain radiotherapy (DBR), and surgery. Results A total of 954 patients were identified. Concerning initial treatment, 525 patients (55.0%) received systemic medication (SM)+BLT, 400 patients (41.9%) received SM only, and 29 patients received BLT only (3.0%). SM+BLT cohort was associated with longer median overall survival (mOS) than the SM only and the BLT only cohorts both in epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK)-negative/unknown patients (15.3 months, 95% confidence interval [CI], 14.2-16.4; 11.1 months, 9.0-13.2; 7.0 months, 5.4-8.6; p<0.001) and in EGFR/ALK-positive patients (33.7 months, 28.5-38.9; 22.1 months, 17.8-26.4; 4.0 months, 3.6-4.4; p < 0.001). As for timing of radiotherapy, SM+EBR (14.1 months, 12.7-15.5) was associated with inferior mOS than SM+DBR (19.4 months, 14.2-24.6) in EGFR/ALK-negative/unknown patients. No significant difference was found in EGFR/ALK-positive patients (28.3 months, 19.1-37.5; 33.3 months, 28.1-38.5). Patients in the EGFR/ALK-negative/unknown cohort treated with first-line pemetrexed with platinum (PP) (15.8 months, 14.0-17.6, p<0.001) had longer mOS than those received non-PP regimens (13.1 months, 11.6-14.6). However, no difference was observed among EGFR/ALK-positive patients who were treated with tyrosine kinase inhibitors (TKIs) (29.5 months, 21.1-37.9; p = 0.140), PP (27.2 months, 21.6-32.8) and non-PP regimens (25.0 months, 16.0-34.0). Conclusions Our study confirmed that the use of SM+BLT is associated with superior mOS than those treated with SM only and BLT only. SM+DBR might be a better radiotherapeutic strategy for this patient population. EGFR/ALK-negative/unknown patients showed a survival benefit with PP treatment.</description><identifier>ISSN: 2234-943X</identifier><identifier>EISSN: 2234-943X</identifier><identifier>DOI: 10.3389/fonc.2020.581729</identifier><identifier>PMID: 33163410</identifier><language>eng</language><publisher>LAUSANNE: Frontiers Media Sa</publisher><subject>brain metastases ; brain radiotherapy ; Life Sciences & Biomedicine ; non-small-cell lung cancer ; Oncology ; Science & Technology ; survival outcomes ; systemic medication</subject><ispartof>Frontiers in oncology, 2020-10, Vol.10, p.581729-581729, Article 581729</ispartof><rights>Copyright © 2020 Chen, Hou, Dinglin, Liu, Li, Zheng, Li, Chen, Wu, Wang, Ma, Zeng and Chen.</rights><rights>Copyright © 2020 Chen, Hou, Dinglin, Liu, Li, Zheng, Li, Chen, Wu, Wang, Ma, Zeng and Chen 2020 Chen, Hou, Dinglin, Liu, Li, Zheng, Li, Chen, Wu, Wang, Ma, Zeng and Chen</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>7</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000581048500001</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c462t-98c807668dbb373e6870cbc64945f5cb5a04b58bed3c0034386f0667f92f80163</citedby><cites>FETCH-LOGICAL-c462t-98c807668dbb373e6870cbc64945f5cb5a04b58bed3c0034386f0667f92f80163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581726/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581726/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2115,27929,27930,28253,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33163410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Xin-Ru</creatorcontrib><creatorcontrib>Hou, Xue</creatorcontrib><creatorcontrib>Dinglin, Xiao-Xiao</creatorcontrib><creatorcontrib>Liu, Yong-Dong</creatorcontrib><creatorcontrib>Li, Yin</creatorcontrib><creatorcontrib>Zheng, Wei</creatorcontrib><creatorcontrib>Li, De-Lan</creatorcontrib><creatorcontrib>Chen, Jing</creatorcontrib><creatorcontrib>Wu, Xiao-Liang</creatorcontrib><creatorcontrib>Wang, Kai-Cheng</creatorcontrib><creatorcontrib>Ma, Shu-Xiang</creatorcontrib><creatorcontrib>Zeng, Yin-Duo</creatorcontrib><creatorcontrib>Chen, Li-Kun</creatorcontrib><title>Treatment Patterns and Survival Outcomes of Non-Small Cell Lung Cancer Patients Initially Diagnosed With Brain Metastases in Real-World Clinical Practice</title><title>Frontiers in oncology</title><addtitle>FRONT ONCOL</addtitle><addtitle>Front Oncol</addtitle><description>Background This study aimed to comprehensively analyze the characteristics, treatment patterns, and survival outcomes of non-small-cell lung cancer (NSCLC) patients initially diagnosed with brain metastases (BMs) in real-world practice. Methods We enrolled NSCLC patients initially diagnosed with BMs between Jan 2004 and Jan 2018 in our institution. Patient demographics, treatment modalities, and survival outcomes were then analyzed. Brain localized treatment (BLT) included early brain radiotherapy (EBR), deferred brain radiotherapy (DBR), and surgery. Results A total of 954 patients were identified. Concerning initial treatment, 525 patients (55.0%) received systemic medication (SM)+BLT, 400 patients (41.9%) received SM only, and 29 patients received BLT only (3.0%). SM+BLT cohort was associated with longer median overall survival (mOS) than the SM only and the BLT only cohorts both in epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK)-negative/unknown patients (15.3 months, 95% confidence interval [CI], 14.2-16.4; 11.1 months, 9.0-13.2; 7.0 months, 5.4-8.6; p<0.001) and in EGFR/ALK-positive patients (33.7 months, 28.5-38.9; 22.1 months, 17.8-26.4; 4.0 months, 3.6-4.4; p < 0.001). As for timing of radiotherapy, SM+EBR (14.1 months, 12.7-15.5) was associated with inferior mOS than SM+DBR (19.4 months, 14.2-24.6) in EGFR/ALK-negative/unknown patients. No significant difference was found in EGFR/ALK-positive patients (28.3 months, 19.1-37.5; 33.3 months, 28.1-38.5). Patients in the EGFR/ALK-negative/unknown cohort treated with first-line pemetrexed with platinum (PP) (15.8 months, 14.0-17.6, p<0.001) had longer mOS than those received non-PP regimens (13.1 months, 11.6-14.6). However, no difference was observed among EGFR/ALK-positive patients who were treated with tyrosine kinase inhibitors (TKIs) (29.5 months, 21.1-37.9; p = 0.140), PP (27.2 months, 21.6-32.8) and non-PP regimens (25.0 months, 16.0-34.0). Conclusions Our study confirmed that the use of SM+BLT is associated with superior mOS than those treated with SM only and BLT only. SM+DBR might be a better radiotherapeutic strategy for this patient population. EGFR/ALK-negative/unknown patients showed a survival benefit with PP treatment.</description><subject>brain metastases</subject><subject>brain radiotherapy</subject><subject>Life Sciences & Biomedicine</subject><subject>non-small-cell lung cancer</subject><subject>Oncology</subject><subject>Science & Technology</subject><subject>survival outcomes</subject><subject>systemic medication</subject><issn>2234-943X</issn><issn>2234-943X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>DOA</sourceid><recordid>eNqNUstu1DAUjRCIVqV7VshLJJTBiR9xNkgQXiMNtKJFZWfdOM7UVWK3tjOon8Lf4jRl1O6wLD_POffq3pNlLwu8IkTUb3tn1arEJV4xUVRl_SQ7LEtC85qSX08fnA-y4xCucBqc4QKT59kBIQUntMCH2Z9zryGO2kZ0CjFqbwMC26Gzye_MDgZ0MkXlRh2Q69F3Z_OzEYYBNTotm8luUQNWaT-TTRIJaG1NNAlyiz4a2FoXdIcuTLxEHzwYi77pCCHNJJhuPzQM-YXzQ4eawVijUsBTDyoapV9kz3oYgj6-34-yn58_nTdf883Jl3XzfpMrysuY10IJXHEuurYlFdFcVFi1itOasp6plgGmLROt7ojCmFAieI85r_q67AVOZTjK1otu5-BKXnszgr-VDoy8e3B-K8GnhAYtWY0rTKBrC0JoCwQEb0tBCCjM645C0nq3aF1P7ag7lSriYXgk-vjHmku5dTtZ3bVwTub1vYB3N5MOUY4mqFRssNpNQZaUiZozQVmC4gWqvAvB634fpsByNoicDSJng8jFIIny6mF6e8I_OySAWAC_dev6oFJLld7DkoOSEKaCzWYqGhNT051t3GRjor75fyr5Cx4s2ZM</recordid><startdate>20201009</startdate><enddate>20201009</enddate><creator>Chen, Xin-Ru</creator><creator>Hou, Xue</creator><creator>Dinglin, Xiao-Xiao</creator><creator>Liu, Yong-Dong</creator><creator>Li, Yin</creator><creator>Zheng, Wei</creator><creator>Li, De-Lan</creator><creator>Chen, Jing</creator><creator>Wu, Xiao-Liang</creator><creator>Wang, Kai-Cheng</creator><creator>Ma, Shu-Xiang</creator><creator>Zeng, Yin-Duo</creator><creator>Chen, Li-Kun</creator><general>Frontiers Media Sa</general><general>Frontiers Media S.A</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20201009</creationdate><title>Treatment Patterns and Survival Outcomes of Non-Small Cell Lung Cancer Patients Initially Diagnosed With Brain Metastases in Real-World Clinical Practice</title><author>Chen, Xin-Ru ; Hou, Xue ; Dinglin, Xiao-Xiao ; Liu, Yong-Dong ; Li, Yin ; Zheng, Wei ; Li, De-Lan ; Chen, Jing ; Wu, Xiao-Liang ; Wang, Kai-Cheng ; Ma, Shu-Xiang ; Zeng, Yin-Duo ; Chen, Li-Kun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-98c807668dbb373e6870cbc64945f5cb5a04b58bed3c0034386f0667f92f80163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>brain metastases</topic><topic>brain radiotherapy</topic><topic>Life Sciences & Biomedicine</topic><topic>non-small-cell lung cancer</topic><topic>Oncology</topic><topic>Science & Technology</topic><topic>survival outcomes</topic><topic>systemic medication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Xin-Ru</creatorcontrib><creatorcontrib>Hou, Xue</creatorcontrib><creatorcontrib>Dinglin, Xiao-Xiao</creatorcontrib><creatorcontrib>Liu, Yong-Dong</creatorcontrib><creatorcontrib>Li, Yin</creatorcontrib><creatorcontrib>Zheng, Wei</creatorcontrib><creatorcontrib>Li, De-Lan</creatorcontrib><creatorcontrib>Chen, Jing</creatorcontrib><creatorcontrib>Wu, Xiao-Liang</creatorcontrib><creatorcontrib>Wang, Kai-Cheng</creatorcontrib><creatorcontrib>Ma, Shu-Xiang</creatorcontrib><creatorcontrib>Zeng, Yin-Duo</creatorcontrib><creatorcontrib>Chen, Li-Kun</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Xin-Ru</au><au>Hou, Xue</au><au>Dinglin, Xiao-Xiao</au><au>Liu, Yong-Dong</au><au>Li, Yin</au><au>Zheng, Wei</au><au>Li, De-Lan</au><au>Chen, Jing</au><au>Wu, Xiao-Liang</au><au>Wang, Kai-Cheng</au><au>Ma, Shu-Xiang</au><au>Zeng, Yin-Duo</au><au>Chen, Li-Kun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment Patterns and Survival Outcomes of Non-Small Cell Lung Cancer Patients Initially Diagnosed With Brain Metastases in Real-World Clinical Practice</atitle><jtitle>Frontiers in oncology</jtitle><stitle>FRONT ONCOL</stitle><addtitle>Front Oncol</addtitle><date>2020-10-09</date><risdate>2020</risdate><volume>10</volume><spage>581729</spage><epage>581729</epage><pages>581729-581729</pages><artnum>581729</artnum><issn>2234-943X</issn><eissn>2234-943X</eissn><abstract>Background This study aimed to comprehensively analyze the characteristics, treatment patterns, and survival outcomes of non-small-cell lung cancer (NSCLC) patients initially diagnosed with brain metastases (BMs) in real-world practice. Methods We enrolled NSCLC patients initially diagnosed with BMs between Jan 2004 and Jan 2018 in our institution. Patient demographics, treatment modalities, and survival outcomes were then analyzed. Brain localized treatment (BLT) included early brain radiotherapy (EBR), deferred brain radiotherapy (DBR), and surgery. Results A total of 954 patients were identified. Concerning initial treatment, 525 patients (55.0%) received systemic medication (SM)+BLT, 400 patients (41.9%) received SM only, and 29 patients received BLT only (3.0%). SM+BLT cohort was associated with longer median overall survival (mOS) than the SM only and the BLT only cohorts both in epidermal growth factor receptor (EGFR)/anaplastic lymphoma kinase (ALK)-negative/unknown patients (15.3 months, 95% confidence interval [CI], 14.2-16.4; 11.1 months, 9.0-13.2; 7.0 months, 5.4-8.6; p<0.001) and in EGFR/ALK-positive patients (33.7 months, 28.5-38.9; 22.1 months, 17.8-26.4; 4.0 months, 3.6-4.4; p < 0.001). As for timing of radiotherapy, SM+EBR (14.1 months, 12.7-15.5) was associated with inferior mOS than SM+DBR (19.4 months, 14.2-24.6) in EGFR/ALK-negative/unknown patients. No significant difference was found in EGFR/ALK-positive patients (28.3 months, 19.1-37.5; 33.3 months, 28.1-38.5). Patients in the EGFR/ALK-negative/unknown cohort treated with first-line pemetrexed with platinum (PP) (15.8 months, 14.0-17.6, p<0.001) had longer mOS than those received non-PP regimens (13.1 months, 11.6-14.6). However, no difference was observed among EGFR/ALK-positive patients who were treated with tyrosine kinase inhibitors (TKIs) (29.5 months, 21.1-37.9; p = 0.140), PP (27.2 months, 21.6-32.8) and non-PP regimens (25.0 months, 16.0-34.0). Conclusions Our study confirmed that the use of SM+BLT is associated with superior mOS than those treated with SM only and BLT only. SM+DBR might be a better radiotherapeutic strategy for this patient population. EGFR/ALK-negative/unknown patients showed a survival benefit with PP treatment.</abstract><cop>LAUSANNE</cop><pub>Frontiers Media Sa</pub><pmid>33163410</pmid><doi>10.3389/fonc.2020.581729</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | brain metastases brain radiotherapy Life Sciences & Biomedicine non-small-cell lung cancer Oncology Science & Technology survival outcomes systemic medication |
| title | Treatment Patterns and Survival Outcomes of Non-Small Cell Lung Cancer Patients Initially Diagnosed With Brain Metastases in Real-World Clinical Practice |
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