Treatment Modes for EGFR Mutations in Patients With Brain Metastases From Non-small Cell Lung Cancer

Controversy, Causes, and Solutions

Hongqing Zhuang; Siyu Shi; Joe Y. Chang


Transl Lung Cancer Res. 2019;8(4):524-531. 

In This Article

Abstract and Introduction


Brain metastasis from non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations is a hot research topic, but also a difficulty in targeted NSCLC therapy, and is also the focus of controversy in the field of lung cancer treatment. According to medical oncology, asymptomatic patients were initially treated with targeted therapy, followed by local radiotherapy when symptoms present or disease progresses. However, from the perspective of the discipline of radiotherapy, brain metastases need to be treated before drug resistance, as it may affect survival. Controversies between disciplines have brought much confusion to the treatment choices of clinicians. We summarized and discussed relevant literatures in this article to seek the truth in providing reference in clinical practice for treating diseases and solving problems.


Over the past decade, targeted therapy for lung cancer has been a major breakthrough in the field of lung cancer treatment. Several significant achievements have been made in lung cancer research, and the survival of non-small cell lung cancer (NSCLC) patients with sensitive mutations has been significantly prolonged.[1–7] However, patients with brain metastases from NSCLC with sensitive mutations have been difficult to manage and have become a hot topic in this field over the past decade.[1–7] In the meantime, due to inconsistent results from various studies and different understandings across disciplines, there are many opinions on exact management of NSCLC brain metastases. The contention is most prominent between medical oncology and radiotherapy oncology, causing much confusion to clinicians in the field. In this article, the relevant literatures were summarized and combined with the authors' own points of view to provide reference for clinical treatment.