Continuous Low-Dose Apatinib Combined With WBRT Significantly Reduces Peritumoral Edema and Enhances the Efficacy of Symptomatic Multiple Brain Metastases in NSCLC
| Autor: | Shan-Bing Wang, Yu-Ming Jia, Yue Ren, Mao-Qiong Jiang, Lin Zhou, Lei-Ya Du, Ting Li, Kai-Jian Lei, Bangxian Tan, Si-Qiao Liu |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Cancer Research Pathology medicine.medical_specialty Lung Neoplasms Pyridines medicine.medical_treatment radiation therapy 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Carcinoma Non-Small-Cell Lung brain metastases medicine Peritumoral edema Edema Humans Apatinib Peritumoral Brain Edema Protein Kinase Inhibitors RC254-282 non-small cell lung cancer 030304 developmental biology Aged Retrospective Studies 0303 health sciences peritumoral brain edema Dose-Response Relationship Drug business.industry Brain Neoplasms Low dose Whole brain radiotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens Chemoradiotherapy Middle Aged Prognosis Radiation therapy Survival Rate Oncology chemistry 030220 oncology & carcinogenesis whole brain radiotherapy Female Original Article Non small cell Cranial Irradiation business apatinib Follow-Up Studies |
| Zdroj: | Technology in Cancer Research & Treatment Technology in Cancer Research & Treatment, Vol 20 (2021) |
| ISSN: | 1533-0338 |
| Popis: | Background: Symptomatic multiple brain metastases with peritumoral brain edema (PTBE) occur in non-small cell lung cancer patients (NSCLC) who are without driver mutations or are resistant to epidermal growth factor tyrosine kinase (EGFR-TKI) are often associated with an unfavorable prognosis. Whole brain radiation therapy (WBRT) which comes with many complications and unsatisfactory effects, is the only option for the treatment. Previous studies have shown that bevacizumab can reduce the volume of PTBE and improve efficiency of radiotherapy. This study evaluated the effects and safety of apatinib combined with WBRT in NSCLC patients with symptomatic multiple brain metastases and PTBE. Methods: We performed a retrospective review of 34 patients with symptomatic multiple brain metastases from NSCLC (number >4, and at least 1 measurable brain metastasis lesion with cerebral edema). Intracranial objective response rate (IORR), peritumoral edema and intracranial tumor volumetric measurement, Karnofsky performance status (KPS) and adverse events (AEs) were evaluated. Median intracranial progression-free survival (mIPFS) and median overall survival (mOS) were also analyzed. Results: Thirteen cases received apatinib (125 mg or 250 mg, QD, oral) combined with WBRT and 21 cases received chemotherapy combined with WBRT were inclued. Apatinib combination group can better reduce the volume of intracranial tumors and PTBE and total steroid dosage used. It was associated with a better IORR (84.6% vs 47.6%, P = 0.067), longer mIPFS (6.97 vs 4.77months; P = 0.014). There was no significant difference in mOS(7.70 vs 6.67 months; P = 0.14) between the 2 groups. The most common adverse events of apatinib combination WBRT included grade 1/2 nausea (4/13), fatigue (3/13), hypertension (2/13) and white blood cell decrease (2/13). No grade 3/4 AEs were observed. Conclusion: Apatinib plus WBRT is well tolerated and may be a potential choice for relapsed or drug-resistant advanced NSCLC patients with symptomatic multiple brain metastases and PTBE. |
| Databáze: | OpenAIRE |
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