{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T07:45:31Z","timestamp":1769845531418,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Reports"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>With more and more target medicine application in lung cancer, lots of patients take medicine at home, the treatment bone metastasis and screen of bone metastasis always has been neglected until skeletal\u2010related events (SREs) such as bone pain, hypercalcemia of malignancy and pathologic fractures emerging which significantly impairs the patients' daily activity ability, seriously lower quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To identify the clinical characteristics of patients which influence the overall survival (OS) of EGFR\u2010TKIs effective in EGFR\u2010mutant NSCLC with bone metastasis (BM) and the bone metastatic image features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective study in patients (treated with EGFR\u2010TKIs \u22656 months) of lung adenocarcinoma with BM in our hospital from October 2014 to October 2017. The Kaplan\u2013Meier survival curves were calculated using the log\u2010rank univariate test. Multivariate regression analysis was conducted using Cox's regression model. Comparison between the different subgroups of bone metastasis was conducted using Pearson Chi\u2010Square test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 79 patients were diagnosed as EGFR\u2010mutant lung adenocarcinoma with bone metastases. At univariate analysis, age\u2009&lt;\u200965 years (<jats:italic>p<\/jats:italic> = .024), heavy smoking (<jats:italic>p<\/jats:italic> = .005), Osteolytic BM (<jats:italic>p<\/jats:italic> = .034), number of bone metastasis \u22653 (<jats:italic>p<\/jats:italic> = .032), EGFR\u2010L858R mutated (<jats:italic>p<\/jats:italic> = .018) and bisphosphonate times &lt;6 (<jats:italic>p<\/jats:italic> = .046), were significantly associated with worse overall survival (OS). At multivariate analysis, EGFR 19del was an independent predictor of better OS (<jats:italic>p<\/jats:italic> = .035). Osteolytic BM was more likely to occur in EGFR\u2010mutant patients (osteolytic vs. sclerotic vs. mixed: 45.57% vs. 34.18% vs. 20.25%). Patients who had received bisphosphonate \u22656 times were less suffer from SRE compared to those treated with bisphosphonate &lt;6 times (<jats:italic>p<\/jats:italic> = .019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion<jats:styled-content>s<\/jats:styled-content>, this retrospective study suggests that for the patients, treated with EGFR\u2010TKIs \u22656\u00a0months, EGFR exon 19 del, osteogenic bone metastasis, bisphosphonate application times \u22656, smoking &lt;400\/day and the number of BM &lt;3 were predictors of better OS (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05). Bisphosphonate times \u22659 should be considered to the patients with BM. SPECT\u2013CT would be an effective correction of SPECT in the patient's bone metastasis examination. During the whole follow\u2010up process, we found by chance that the change of bone mineral density in the follow\u2010up process suggested that bisphosphonates need to be used for more than 1\u2009year or more, and we can use local CT in the follow\u2010up clinical practice to confirm the bone density changes to decide when we could stop or reduce bisphosphonate application.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cnr2.1628","type":"journal-article","created":{"date-parts":[[2022,5,26]],"date-time":"2022-05-26T04:30:27Z","timestamp":1653539427000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Retrospective study of <scp>EGFR<\/scp>\u2010mutant lung adenocarcinoma with bone metastatic clinical features"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4609-3578","authenticated-orcid":false,"given":"Liyan","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Tianjin Medical University General Hospital  Tianjin PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ting","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tianjin Medical University General Hospital  Tianjin PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tianjin Medical University General Hospital  Tianjin PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diansheng","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Tianjin Medical University General Hospital  Tianjin PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,5,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep18670"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20308"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1525\u20107304(11)70347\u20103"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/ctrv.2000.0210"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011954"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdl377"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3111\/13696998.2011.632044"},{"issue":"4","key":"e_1_2_11_10_1","first-page":"3133","article-title":"Rapid infusion of ibandronate in lung cancer patients with bone metastases","volume":"26","author":"Kiagia M","year":"2006","journal-title":"Anticancer Res"},{"issue":"1","key":"e_1_2_11_11_1","first-page":"529","article-title":"Safety and efficacy of zoledronic acid rapid infusion in lung cancer patients with bone metastases: a single institution experience","volume":"28","author":"Kotteas E","year":"2008","journal-title":"Anticancer Res"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000009327"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv190"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1586\/era.10.63"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2015.06.004"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970\u20102113.106127"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0b013e3283399107"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259\u2010009\u20101334\u20103"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc867"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.12659\/msm.902971"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010007\u20100051\u20100"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2014.08.022"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.51.6596"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l5460"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cllc.2011.09.004"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.58.1736"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tips.2015.04.006"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40644\u2010019\u20100221\u20109"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep43399"},{"issue":"1","key":"e_1_2_11_30_1","first-page":"38","article-title":"New development in bisphosphonate treatment. 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