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Concomitant radiotherapy and TKI in metastatic EGFR- or ALK-mutated non-small cell lung cancer: a multicentric analysis on behalf of AIRO lung cancer study group

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Abstract

Purpose

To investigate the role of radiotherapy (RT) in the management of EGFR- or ALK-mutated metastatic non-small cell lung cancer (NSCLC) treated with TKI.

Materials and methods

Clinical data of 106 patients (pts) from five Institutions treated with RT concomitant to TKI were retrospectively revised. Overall survival (OS) and toxicities were analyzed as endpoints of the study.

Results

Median age of pts was 65 years. TKIs were given for EGFR (81%)- or ALK (19%)-mutated metastatic NSCLC. Stereotactic RT (SRT) was delivered to 49 pts (46%). Patients with four or less metastasis were defined as oligometastatic/oligoprogressive (OM/OP); sites of RT were brain, bone, lung or others in 46%, 27%, 14% and 13%, respectively. Median OS was 23 months. At univariate analysis SRT, ECOG PS 0–1, OM/OP disease, lung sites and a TKI duration longer than median favorably affected OS (all p < 0.001). Multivariate analysis confirmed SRT (HR 0.355, CI 95% 0.212–0.595; p < 0.001) and median duration of TKI > 14 months (HR 0.17, 95% CI 0.10–0.30; p < 0.001) as independent factors related to better OS. Toxicities were rare.

Conclusions

SRT seems to positively affect OS with limited toxicity in selected patients.

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Authors and Affiliations

  1. Department of Radiation Oncology, Istituto del Radio O. Alberti, Spedali Civili Hospital and Brescia University, Brescia, Italy

    Paolo Borghetti, Marco Lorenzo Bonù, Luca Triggiani & Stefano Maria Magrini

  2. Radiotherapy Unit, Oncology and Hematology Department, University Hospital of Modena, Modena, Italy

    Rachele Giubbolini & Alessio Bruni

  3. Department of Radiation Oncology, Sacro Cuore Hospital, Negrar, Italy

    Niccolo’ Giaj Levra & Rosario Mazzola

  4. Department of Oncology Radiation Therapy Unit, Careggi University Hospital, Florence, Italy

    Marco Perna, Luca Visani, Fiammetta Meacci & Vieri Scotti

  5. Radiotherapy Unit, SS Annunziata Hospital – G. D’annunzio University, Chieti, Italy

    Maria Taraborrelli

  6. Department of Radiotherapy and Radiosurgery, Humanitas Research Hospital and Cancer Center, Milan, Rozzano, Italy

    Davide Franceschini

  7. Departement of Radiation Oncology, Campus Bio-Medico University, Rome, Italy

    Carlo Greco

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  1. Paolo Borghetti
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Correspondence to Marco Lorenzo Bonù.

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The study was performed in accordance with the Declaration of Helsinki. The authors agree with the content of the article and give consensus for publication.

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Borghetti, P., Bonù, M.L., Giubbolini, R. et al. Concomitant radiotherapy and TKI in metastatic EGFR- or ALK-mutated non-small cell lung cancer: a multicentric analysis on behalf of AIRO lung cancer study group. Radiol med 124, 662–670 (2019). https://doi.org/10.1007/s11547-019-00999-w

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  • DOI: https://doi.org/10.1007/s11547-019-00999-w

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