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Clinical outcomes of thoracic radiotherapy for locally advanced NSCLC with EGFR mutations or EML4-ALK rearrangement.

BACKGROUND
Little is known about the occurrence and consequences of epidermal growth factor receptor gene (EGFR) mutations and the fusion of the echinoderm microtubule-associated protein-like 4 (EML4) and anaplastic lymphoma kinase (ALK) genes in locally advanced non-small cell lung cancer (NSCLC).


PATIENTS AND METHODS
We retrospectively examined 37 patients with locally advanced NSCLC treated with definitive thoracic radiotherapy (TRT). Characteristics were compared among patients classified positive for EGFR mutations, EML4-ALK rearrangement, or patients who were double-negative for these changes.


RESULTS
We identified 11 (29.7%) patients with EGFR mutations and 3 (8.1%) with an EML4-ALK rearrangement. Progression-free survival of patients with EGFR mutation-positive NSCLC was similar to the one of those with double-negative disease (13.1 and 18.6 months). The incidence of local recurrence was higher in EGFR mutation-positive patients with NSCLC than in double-negative NSCLC.


CONCLUSION
EGFR mutations and the EML4-ALK rearrangements were detected in substantial proportions of patients with locally advanced NSCLC. The efficacy of TRT was limited in patients with EGFR mutations.