{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:15:53Z","timestamp":1790288153315,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:00:00Z","timestamp":1714003200000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To elucidate the potential benefits of combining radiotherapy and epidermal growth factor receptor\u2010tyrosine kinase inhibitors (EGFR\u2010TKIs) for individuals with Stage IV lung adenocarcinoma (LUAD) harboring either exon 19 deletion (<jats:italic>19\u2010Del<\/jats:italic>) or exon 21 <jats:italic>L858R<\/jats:italic> mutation (<jats:italic>21\u2010L858R<\/jats:italic>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this real\u2010world retrospective study, 177 individuals with Stage IV LUAD who underwent EGFR\u2010TKIs and radiotherapy at Shandong Cancer Hospital from June 2012 to August 2017 were included. The main focus of this real\u2010world study was overall survival (OS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The clinical characteristics of patients with Stage IV LUAD harboring <jats:italic>19\u2010Del<\/jats:italic> were similar to those harboring <jats:italic>21\u2010L858R<\/jats:italic> (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Overall, the patients had a median OS (mOS) of 32.0\u2009months (95% confidence interval [CI]: 28.6\u201335.5). Subsequently, multivariate analysis indicated that both <jats:italic>EGFR<\/jats:italic> mutations and thoracic radiotherapy were independent predictors of OS (<jats:italic>p<\/jats:italic>\u2009=\u20090.001 and 0.013). Furthermore, subgroup analysis highlighted a longer OS for the <jats:italic>19\u2010Del<\/jats:italic> group compared to the <jats:italic>21\u2010L858R<\/jats:italic> group, especially when EGFR\u2010TKIs were combined with bone metastasis or thoracic radiotherapy (mOS: 34.7 vs. 25.1\u2009months and 51.0 vs. 29.6\u2009months; <jats:italic>p<\/jats:italic>\u2009=\u20090.0056 and 0.0013, respectively). However, no significant differences were found in OS when considering patients who underwent brain metastasis radiotherapy (mOS: 34.7 vs. 25.1\u2009months; <jats:italic>p<\/jats:italic>\u2009=\u20090.088).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with Stage IV LUAD harboring 19\u2010Del experience a notably prolonged OS following combined therapy with EGFR\u2010TKIs and radiotherapy, while this OS benefit is observed despite the absence of substantial differences in the clinical characteristics between the <jats:italic>19\u2010Del<\/jats:italic> and <jats:italic>21\u2010L858R<\/jats:italic> groups.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7208","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T07:23:18Z","timestamp":1714029798000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic implications of combining <scp>EGFR\u2010TKIs<\/scp> and radiotherapy in Stage <scp>IV<\/scp> lung adenocarcinoma with <scp>19\u2010Del<\/scp> or <scp>21\u2010L858R<\/scp> mutations: A <scp>real\u2010world<\/scp> study"],"prefix":"10.1002","volume":"13","author":[{"given":"Shuai","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Oncology The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Medical Center  Wuxi China"},{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanyu","family":"Wang","sequence":"additional","affiliation":[{"name":"The Affiliated Children's Hospital of Jiangnan University, Wuxi School of Medicine  Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"},{"name":"Department of oncology Shengli Oilfield Central Hospital  Dongying China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Oncology The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Medical Center  Wuxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences  Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9906-3252","authenticated-orcid":false,"given":"Dong","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Oncology The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi Medical Center  Wuxi China"},{"name":"The Affiliated Children's Hospital of Jiangnan University, Wuxi School of Medicine  Wuxi 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