PUB121 Assessment of Prognostic Scores in Brain Metastases from Lung Adnocarcinoma with Status of EGFR Mutations

Our purpose was to analyze the prognostic factor and evaluate the value of four prognostic scores including RPA, DS-GPA BS-BM, GGS for the EGFR mutant BM patients from lung adenocarcinoma treated with EGFR-TKI. The data of NSCLC were retrospectively reviewed from August 2010 to June 2015 in medical database of Shanxi Provincial Cancer Hospital. Patients with BM from lung adenocarcinoma identified with EGFR mutations received treatment of EGFR-TKI or combination of EGFR-TKI plus WBRT were included. Potential prognostic factors were examined in uni=variable and multivariable analyses. To compare the predictive values of each scoring system, the C-index of each prognostic score were calculated. A total of 1063 BM patients with lung adenocarcinoma identified with status of EGFR mutations between August 2010 and June 2015 from lung cancer medical database was reviewed. Among them, 104 patients who diagnosed with BM confirmed with status of EGFR mutations in primary tumors. They received treatment of EGFR-TKI or EGFR –TKI plus WBRT to BM. The median survival was 15.83 months (95%CI 14.30-17.36). The 1 year survival rate was 60.3 %. The potential predictive factors in multivariable analysis included KPS (70 vs.70-80 vs.90-100), and number of brain metastatic lesions. In log-rank test, the indexes of RPA, DS-GPA BS-BM, GGS were all significant predictors of OS(p<0.001). The C-index value of each prognostic scores were 0.79,0.76,0.77,0.74 in DS-GPA,RPA,GGS,BS-BM respectively. The indexes of RPA, DS-GPA BS-BM, GGS were applicable for assessing survival stratification in brain metastases from lung adnocarcinoma with status of EGFR mutations in our independent population. The DS-GPA seems the best predictive value. However, all of the four indexes could not cover the exact independent prognostic factors in multivariable analysis. A new prognostic index specific for this group of patients was needed in the era of lung cancer target therapy.