Overview

The Role of Brain Radiotherapy in Patients With Asymptomatic Brain Metastasis in the Era of Targeted Therapy for NSCLC

Status:
Not yet recruiting
Trial end date:
2022-06-01
Target enrollment:
0
Participant gender:
All
Summary
Brain metastasis is the most common neurological complication in tumor patients, and lung cancer is the most common tumor with brain metastasis. The prognosis of patients with non-small cell lung cancer with brain metastasis is poor. If not treated, the median survival time was about 1 month, the median survival time for steroid therapy was about 2 to 3 months, and the median survival time for patients receiving whole brain radiotherapy was about 3 to 6 months. Studies have shown that the incidence of brain metastasis is not only related to tumor size, N stage and tumor cell type, but also more likely to occur in NSCLC patients with sensitive gene mutation. With the rapid development of NSCLC molecular targeted therapy and precise radiotherapy, the new main therapeutic methods for NSCLC brain metastasis in recent years include stereotactic radiotherapy for (SRT),. Based on intensity modulated technique, simultaneous modulated accelerated radiation therapy for Brain(SMART-Brain) and molecular targeted therapy were carried out. However, at present, the best treatment choice for NSCLC brain metastasis, especially for asymptomatic brain metastasis patients, is still controversial. The choice and combined application mode of individualized treatment for different patients is still a problem to be explored. Based on the synergistic effect of radiotherapy and molecular targeted therapy on the basis of cell and molecule, The purpose of this study was to prospectively compare the efficacy of radiotherapy combined with targeted therapy and targeted therapy alone in patients with asymptomatic NSCLC brain metastasis with gene sensitive mutations, and subgroup analysis of different molecular targets and mutation sites. It is expected that this study will provide a basis for optimizing the curative effect of patients with NSCLC brain metastasis.
Phase:
Phase 2
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Second Affiliated Hospital of Nanchang University
Collaborator:
Nanchang University
Criteria
Inclusion Criteria:

- Histology confirmed that it was non-small cell lung cancer;

- EGFR, ALK or ROS1 gene detection showed sensitive gene mutation, and patients were
willing to receive targeted therapy;

- brain MRI confirmed brain metastasis;

- asymptomatic or symptomatic brain metastasis could be controlled by glucocorticoid;

- PS score 0-1;

- no brain radiotherapy or targeted therapy before entering the group;

- there was no history of malignant tumor and no serious medical diseases;

- Laboratory examination: White blood cell count ≥ 4 *10^9/L, neutrophil count ≥ 2.0
*10^9, platelet count ≥ 100 *10^9, hemoglobin ≥ 10 g / L, liver and kidney function
and ECG were normal;

- the pregnancy test was negative within 3 days before entering the group, and agreed to
use medically effective contraceptives during the experiment;

- sign informed consent form.

Exclusion Criteria:

- Small cell lung cancer was confirmed by pathology;

- other malignant tumors (unless PFS ≥ 3 years, except non-black skin cancer);

- were treated with brain radiotherapy or targeted therapy before;

- those with other potentially serious diseases (congestive heart failure, transmural
myocardial infarction, admission with severe acute bacterial or fungal infection, COPD
or other respiratory diseases that affect treatment, etc.), Taking into account that
the study may exacerbate or fail to control the disease;

- severe immunosuppressive diseases, such as AIDS;

- pregnant women, lactating women or women of childbearing age who do not agree with the
use of effective contraception in the trial;

- Intracranial metastasis with obvious symptoms or symptoms that can not be relieved by
glucocorticoid alone