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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2018.125    [Accepted]
EGFR Mutation is Associated with Short Progression Free Survival in Patients with Stage III Non-Squamous Cell Lung Cancer Treated with Concurrent Chemoradiotherapy
Song Ee Park1, Jae Myoung Noh2, You Jin Kim3, Han Sang Lee3, Jang Ho Cho3, Sung Won Lim3, Yong Chan Ahn2, Hongryull Pyo2, Yoon-La Choi4, Joungho Han4, Jong-Mu Sun3, Se Hoon Lee3, Jin Seok Ahn3, Keunchil Park3, Myung-Ju Ahn3
1Division of Hematology-Oncology, Department of Medicine, Chung-Ang University College of Medicine, Seoul, Korea
2Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
3Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
4Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Correspondence  Myung-Ju Ahn ,Tel: 82-2-3410-3438 , Fax: 82-2-3410-1754 , Email: silk.ahn@samsung.com
Received: February 27, 2018;  Accepted: June 10, 2018.  Published online: June 18, 2018.
*Song Ee Park and Jae Myoung Noh contributed equally to this work.
ABSTRACT
Purpose
This study was conducted to evaluate the relationship between epidermal growth factor receptor (EGFR) mutation and clinical outcomes in patients with stage III non-squamous cell lung cancer treated with definitive concurrent chemoradiotherapy (CCRT).
Materials and Methods
From January 2008 to December 2013, the medical records of 197 patients with stage III non- squamous non-small cell lung cancer (NSCLC) treated with definitive CCRT were analyzed to determine progression free survival (PFS) and overall survival (OS) according to EGFR mutation status.
Results
Among 197 eligible patients, 81 patients were EGFR wild type, 36 patients had an EGFR mutation (exon 19 Del: 18; L858R: 9, Uncommon [G719X, L868, T790M]: 9), and 80 patients had unknown EGFR status. The median age was 59 years (range: 28 - 80) and 136 (69.0%) patients were male. The median follow-up duration was 66.5 months (range: 1.9 - 114.5). One hundred sixty-four patients (83.2%) experienced disease progression. Median PFS was 8.9 months for the EGFR mutation group, 11.8 months for EGFR wild type, and 10.5 months for the unknown EGFR group (p=0.013, p=0.042). The most common site of metastasis in the EGFR mutant group was the brain. However, there was no significant difference in overall survival among the three groups (34.6 months for EGFR mutant group vs. 31.9 months for EGFR wild type vs. 22.6 months for EGFR unknown group, p=0.792, p=0.284). A total of 29 (80.6%) patients with EGFR mutation were treated with EGFR tyrosine kinase inhibitor (TKI)s (gefitinib: 24, erlotinib: 3, afatinib: 2) upon progression.
Conclusion
EGFR mutation is associated with short PFS and the brain is the most common site of distant metastasis in patients with stage III non- squamous cell lung cancer treated with CCRT.
Key words: Non-squamous non-small cell lung cancer, Chemoradiotherapy, Stage III, EGFR mutation, Survival
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