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Benefit from Adjuvant TKIs Versus TKIs Plus Chemotherapy in EGFR-Mutant Stage III-pN2 Lung Adenocarcinoma
| Content Provider | MDPI |
|---|---|
| Author | Li, Qiwen Ma, Li Qiu, Bo Wen, Yuzhi Liang, Wenhua Hu, Wanming Chen, Naibin Zhang, Tian Xu, Shuangbing Chen, Lingjuan Guo, Minzhang Zhao, Yi Liu, Songran Guo, Jinyu Wang, Junye Wang, Siyu Wang, Xin Pang, Qingsong Long, Hao Liu, Hui |
| Copyright Year | 2021 |
| Abstract | Background: Recent studies have demonstrated benefits from adjuvant tyrosine-kinase inhibitors (TKIs) compared with chemotherapy in non-small cell lung cancer. We launched a multi-center retrospective study to evaluate the efficacy and toxicity of adjuvant TKIs with or without chemotherapy in epidermal growth factor receptor (EGFR)-mutant stage III-pN2 lung adenocarcinoma. Methods: Two hundred and seventy-four consecutive cases with stage III-pN2 lung adenocarcinoma and complete resection have been investigated. Clinic-pathologic characteristics, adjuvant treatments, long-term survivals, and toxicities were documented. Risk factors of distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival (OS) were evaluated. Results: There were 52 (19.0%) patients treated with adjuvant TKIs alone, 199 (72.6%) with adjuvant chemotherapy alone, and 23 (8.4%) with both. After a median follow-up time of 29 months, the two-year DMFS, DFS, and OS was 61.2%, 54.1%, and 91.2%, respectively. According to univariable analyses, the risk factors were lymphovascular invasion (p < 0.001), extranodal extension (p = 0.005), and adjuvant systemic therapy (p = 0.006) for DMFS, EGFR mutation type (p = 0.025), lymphovascular invasion (p = 0.013), extranodal extension (p = 0.004), and adjuvant systemic therapy (p < 0.001) for DFS, and EGFR mutation type (p < 0.001) for OS. Multivariable analyses indicated that the independent prognostic factors were adjuvant systemic therapy (TKIs vs. TKIs+chemotherapy, Harzard ratio (HR) = 0.40; p = 0.036; TKIs vs. chemotherapy, HR = 0.38; p = 0.004), lymphovascular invasion (yes vs. no, HR = 2.22; p = 0.001) for DMFS, and adjuvant systemic therapy (TKIs vs. TKIs+chemotherapy, HR = 0.42; p = 0.034; TKIs vs. chemotherapy, HR = 0.33; p < 0.001) for DFS. No significant difference was found in the incidence of Grade 3–4 toxicities between groups (p = 0.445). Conclusions: Adjuvant TKIs might be a beneficial choice compared with adjuvant chemotherapy or combination systemic treatments. |
| Ending Page | 1436 |
| Page Count | 13 |
| Starting Page | 1424 |
| e-ISSN | 17187729 |
| DOI | 10.3390/curroncol28020135 |
| Journal | Current Oncology |
| Issue Number | 2 |
| Volume Number | 28 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-04-07 |
| Access Restriction | Open |
| Subject Keyword | Current Oncology Oncology Lung Adenocarcinoma Egfr Mutation Adjuvant Tkis Chemotherapy |
| Content Type | Text |
| Resource Type | Article |
