Impact of TP53 mutations on brain metastasis control in non-small cell lung cancer patients undergoing stereotactic radiosurgery.

IF 0.8 Q4 SURGERY Journal of radiosurgery and SBRT Pub Date : 2024-01-01
Jim X Leng, Chang Su, David J Carpenter, Warren Floyd, Eugene Vaios, Rachel Shenker, Peter G Hendrickson, Will Giles, Trey Mullikin, Scott R Floyd, John P Kirkpatrick, Michelle Green, Zachary J Reitman
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Abstract

Purpose: To investigate whether TP53 variants may be correlated with overall survival and local control following stereotactic radiosurgery (SRS) for brain metastases (BMs) from non-small cell lung cancer (NSCLC).

Methods: Patients undergoing an initial course of SRS for NSCLC brain metastases between 1/2015 and 12/2020 were retrospectively identified. Overall survival and freedom from local intracranial progression (FFLIP) were estimated via Kaplan-Meier method. Cox models assessed TP53 variant status (pathogenic variant, PV; variant not detected, ND).

Results: 255 patients underwent molecular profiling for TP53, among whom 144 (56%) had a TP53 PV. Median follow-up was 11.6 months. OS was not significantly different across TP53 status. A trend toward superior FFLIP was observed for PV (95% CI 62.9 months-NR) versus ND patients (95% CI 29.4 months-NR; p=0.06). Superior FFLIP was observed for patients with one TP53 variant versus those with TP53 ND.

Conclusion: Among NSCLC patients with BMs, the potential association between TP53 status and post-SRS FFLIP warrants further investigation in a larger prospective cohort.

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TP53突变对接受立体定向放射手术的非小细胞肺癌患者脑转移控制的影响
目的:研究TP53变异是否与非小细胞肺癌(NSCLC)脑转移瘤(BMs)立体定向放射外科手术(SRS)后的总生存率和局部控制率相关:方法:对2015年1月1日至2020年12月12日期间因NSCLC脑转移接受SRS初始疗程的患者进行回顾性鉴定。通过卡普兰-梅耶法估算总生存期和颅内局部进展自由度(FFLIP)。Cox模型评估了TP53变异状态(致病变异,PV;未检测到变异,ND)。结果:255名患者接受了TP53分子分析,其中144人(56%)有TP53变异。中位随访时间为 11.6 个月。不同 TP53 状态的 OS 无明显差异。观察到PV(95% CI 62.9个月-NR)与ND患者(95% CI 29.4个月-NR;P=0.06)相比,FFLIP呈上升趋势。TP53变异患者的FFLIP优于TP53 ND患者:在患有BMs的NSCLC患者中,TP53状态与SRS后FFLIP之间的潜在关联值得在更大的前瞻性队列中进一步研究。
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CiteScore
1.40
自引率
8.30%
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