| Popis: |
Objectives: The goal of this study was to evaluate whether the presence of EGFR (Epidermal Growth Factor Receptor) mutations in patients with NSCLC treated by radiochemotherapy, would have an impact on the disease prognosis and survival. Materials and methods: This was a historical/retrospective cohort study using data and history from patients treated at Regiomed Klinikum Coburg between 2016 and 2020, based on specific and predefined inclusion and exclusion criteria. Out of 432 patients with lung cancer, 336 patients were excluded for various reasons (small cell histology, prior surgery, metastatic or recurrent disease, stereotactic radiosurgery). 87 patients were included in this study, 14 of these patients harboring EGFR mutations. Patient characteristics analyzed were familial predisposition, Karnofsky-performance status, history of smoking, type of therapy received, any recurrence and its location, as well as possible toxicity due to the therapy. Using the Kaplan-Meier method, overall survival rates of patients was analyzed according to the mutation status, age, stage of disease at time of diagnosis and gender and compared by the logrank-test, The statistical data was analyzed with IBM SPSS Statistics for Windows 26 (IBM Corp, 2019). Patient data was supplemented from public databases whenever possible. Results: The median age of patients was 74±11 years. Five-year overall survival rate (5y-OS) for all 87 patients was 49%, 5y-OS of patients older than 74 years was 40%, for those being younger 59% (P=0.13). Patients with EGFR mutation (n=14) and patients without the mutation (n=73) had a 5y-OS of 64% and 41%, respectively (P=0.23). 5-year-survival was 46% in patients with stages 1-2B, 38% in patients with stage 3A, 59% in stage 3B and 53% in patients with stages 3C-4 (P=0.71). This study did show a significant increase in survival for female patients compared to male patients, with 66% vs 38%, respectively (P=0.019). Conclusions: In patients with (mainly) stage 3 non-small cell lung cancer treated by definitive radiochemotherapy, excellent overall 5-year-survival rates around 50% were obtained. Patients with EGFR-mutated tumors (n=14) had a better survival rate as compared to patients without EGFR-mutated tumors (n=73), albeit reaching no statistical significance. This may be attributed to the small patient number with EGFR-positive tumors. Ciljevi: Cilj ovog istraživanja bio je procijeniti hoće li prisutnost EGFR mutacija u bolesnika s NSCLC, a koji su liječeni radio kemoterapijom, imati utjecaja na prognozu bolesti i preživljenje. Materijali i metode: Ovo je bila povijesna/retrospektivna kohortna studija u kojoj su se koristili podaci i povijest pacijenata liječenih u Regiomed Klinikum Coburg u periodu od 2016. do 2020. godine, na temelju specifičnih i unaprijed definiranih kriterija uključivanja i isključivanja. Od 432 pacijenta s karcinomom pluća, 336 pacijenata bilo je isključeno iz različitih razloga (histologija malih stanica, prethodni kirurški zahvat, metastatska ili rekurentna bolest, stereotaktička radiokirurgija). U ovu studiju bilo je uključeno 87 pacijenata od kojih je 14 pacijenata imalo EGFR mutacije. Analizirane karakteristike pacijenata bile su: obiteljska predispozicija, status Karnofsky-jevog učinka, povijest pušenja, vrsta primljene terapije, svaki recidiv i njegova lokacija, kao i moguća toksičnost zbog terapije. Koristeći Kaplan-Meierovu metodu analizirane su ukupne stope preživljavanja pacijenata prema statusu mutacije, dobi, stadiju bolesti u trenutku dijagnoze i spolu te su uspoređene logrank testom. Statistički podaci analizirani su pomoću IBM SPSS Statistike za Windows 26 (IBM Corp, 2019.). Podaci o pacijentima dopunjavani su iz javnih baza podataka kad god je to bilo moguće. Rezultati: Srednja dob pacijenata bila je 74±11godina. Petogodišnja ukupna stopa preživljavanja (5y-OS) za svih 87 pacijenata bila je 49%, 5y-OS pacijenata starijih od 74 godine bila je 40%, za one mlađe 59% (P=0,13). Pacijenti s mutacijom EGFR (n=14) i pacijenti bez mutacije (n=73) imali su 5y-OS od 64% odnosno 41% (P=0,23). Petogodišnje preživljenje bilo je 46% u bolesnika sa stadijima 1-2B, 38% u bolesnika sa stadijem 3A, 59% u stadiju 3B i 53% u bolesnika sa stadijima 3c-4 (P=0,71). Ova studija je pokazala značajno povećanje preživljenja za žene u usporedbi s muškim pacijentima, i to 66% u odnosu na 38% (P=0,019). Zaključci: U pacijenata s (uglavnom) stadijem III karcinoma pluća nemalih stanica, liječenih definitivnom radiokemoterapijom, postignute su izvrsne ukupne stope petogodišnjeg preživljenja od oko 50%. Pacijenti s EGFR-mutiranim tumorima (n=14) imali su bolju stopu preživljavanja u usporedbi s bolesnicima bez EGFR-mutiranih tumora (n=73), iako nisu postigli statističku značajnost. To se može pripisati malom broju pacijenata s EGFR-pozitivnim tumorima. |
