Table 2. Stereotactic ratiotherapy combined with targeted therapy or immunotherapy for brain metastases of NSCLC.
Reference | Study type | Study population | Treatment | Toxicity | Intracranial response | Median overall survival |
Magnuson 2017 (5) | retrospective | n = 351 | – RC followed by EGFR-TKI – WBRT followed by EGFR-TKI – EGFR-TKI followed by RS or WBRT in case of intracranial progression |
not reported | freedom from intracranial progression (median): RS 23 m (HR: 0.73; 95% CI: [0.52; 1.02]), WBRT 24 m (HR: 0.92 [0.66; 1.29]), EGFR-TKI: 17 m |
RS: 46 m (HR: 0.39 [0.26; 0.58]),WBRT: 30 m (HR 0.70 [50%; 98%]), EGFR-TKI: 25 m |
Miyawaki 2019 (6) | retrospective | n = 176 | – initial EGFR-TKI – initial local therapy |
not reported | freedom from intracranial progression (median): 12 m versus 22 m (HR: 0.54 [0.36; 0.79]) |
23 m versus 28 m (HR: 0.75 [0.52; 1.07]), subgroup with 1–4 BM: 23 m versus 35 m (HR: 0.57 [0.34; 0.91]) |
Lee 2019 (7) | retrospective | n = 198 | – initial WBRT – initial RS – delayed RT in case of intracranial progression – no intracranial RT |
not reported | freedom from intracranial progression (median): initial WBRT or RS: delayed RT or no RT: 11.7 m (p < 0.001) |
initial WBRT: 18.5 m, initial RS: 55.7 m, delayed RT in case of intracranial progression: 21.1 m, no intracranial RT: 18.2 m (p = 0.008) |
BM, brain metastasis (-es); EGFR, epidermal growth factor receptor; HR, hazard ratio; m, months; NSCLC, non-small-cell lung cancer;
RS, radiosurgery; RT, radiotherapy; TKI, tyrosine kinase inhibitor; WBRT, whole-brain radiation therapy; 95% CI, 95% confidence interval