Stereotactic Radiosurgery Combination With Anlotinib for Limited Brain Metastases in NSCLC

This is a retrospective study. The purpose of this study is to determine whether stereotactic radiosurgery combination with Anlotinib could improve the efficacy and outcomes for non-small cell lung cancer with limited brain metastases. Patients in Anlotinib group took Anlotinib 1 week before the MRI-based simulation，12mg/d QD，day1~14, 21d/cycle. Patients in SBRT group took no anti-angiogenic drugs. All patients received SBRT for brain metastases.

Inclusion criteria

• Patients pathologically diagnosed as non-small cell lung cancer, with brain metastases and measurable lesions;
• Patients aged between 18 -80 years; with expected survival time>3 months.
• Patients with no more than 5 brain metastases
• Patients with normal organ function within 7 days prior to treatment, the following criteria are met:

• blood routine examination criteria : i) hemoglobin (HB) ≥90g/L; ii) absolute neutrophil count (ANC) ≥1.5×10e9/L; iii) platelet (PLT) ≥80×10e9/L; b) biochemical tests meet the following criteria: i) total bilirubin (TBIL) ≤1.5 times of upper limit of normal (ULN); ii) alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤2.5 ULN, if liver metastasis occurred, ALT and AST ≤5 ULN; iii) serum creatinine (Cr) ≤1.5 ULN or creatinine clearance (CCr) ≥60mL/min;

Exclusion criteria

• Patients who had previously used antiangiogenic agents within 1 month;
• Patients with small cell lung cancer (including small cell carcinoma and non-small cell carcinoma mixed lung cancer);
• Patient with lung squamous cell carcinoma that involved pulmonary hilar, or non-small cell lung cancer with hemoptysis;
• Patients with cerebral infarction and cerebral hemorrhage;
• Patients without perilesional edema；
• Patients with more than grade 2 (NCI-CTCAE v4.0) acute toxicity reaction due to any previous treatment.
• Patients with factors that affect oral medication (such as cannot swallow, chronic diarrhea and intestinal obstruction, etc.);
• Patients with visceral dissemination or severe symptoms, which could cause death in short term;
• Patients with any other severe and/or uncontrolled disease;
• Patients who received a surgery, a biopsy or a significant traumatic injury within 1 month;
• Patients with any signs or medical history of bleeding, unhealed wounds, ulcers or fractures, regardless of the severity;
• Patients underwent artery or venous thrombotic events within 2 months, such as deep vein thrombosis and pulmonary embolism;
• Patients with a history of psychotropic medicine abuse and cannot quit or have mental disorders;
• Patients with disease which will severely endanger their security and could not complete this study, according to the judgement of researchers；