APMAdvances in Precision Medicine2424-85922424-9106WHIOCE PUBLISHING PTE. LTD.10.18063/APM.v11i4.1842ArticleImpact of Thoracic Radiotherapy Timing on Resistance and Survival in Patients with Advanced EGFR-Mutant Lung Adenocarcinoma Treated with EGFR Tyrosine Kinase Inhibitorshttps://artdesignp.com/journal/APM/11/4/10.18063/APM.v11i4.1842ZhaoChenran20261142026-04-26Objective: We evaluated whether thoracic radiotherapy before acquired epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) resistance improves survival in stage IV EGFR-mutant lung adenocarcinoma. Methods: We reviewed 182 patients with stage IV EGFR-mutant lung adenocarcinoma who received EGFR-TKIs and thoracic radiotherapy at one cancer center. We assigned 120 patients to a pre-resistance radiotherapy group and 62 patients to a post-resistance radiotherapy group according to radiotherapy timing. Overall survival (OS) and thoracic progression-free survival (tPFS) served as co-primary endpoints. Metastatic progression-free survival (mPFS) served as a secondary endpoint. We used Kaplan-Meier analysis, log-rank testing, Cox regression, and chi-square testing. Results: Median OS was 59.4 months and 38.8 months, respectively (log-rank test P = 0.0489, hazard ratio [HR]: 0.6965, 95% CI: 0.4678–0.9037), and median tPFS was 33.9 months and 16.1 months, respectively (log-rank test P = 0.0005, HR: 0.5334, 95% CI: 0.3487–0.8161). The mPFS was 34.8 months and 26.9 months, respectively (log-rank test P = 0.0615, HR: 0.7985, 95% CI: 0.5266–1.134). The results of univariate and multivariate Cox regression analysis showed that timing of thoracic radiotherapy (P = 0.048) was an independent indicator of improved survival outcomes in patients with EGFR-mutant lung adenocarcinoma. Conclusion: Thoracic radiotherapy before acquired resistance correlated with longer survival and stronger thoracic disease control in advanced EGFR-mutant lung adenocarcinoma.Advanced lung adenocarcinoma,EGFR-TKIs,Thoracic radiotherapy,Overall survival

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