为了研究SRS和TKI对EGFR突变NSCLC患者脑转移的差异效应以及在出现新的脑转移时继续使用相同的TKI药物的结果。本研究纳入了608例NSCLC患者（2,274个脑转移），而荟萃分析纳入了1,651例NSCLC患者（>3,944个脑转移）。采用Kaplan-Meier方法评估总生存期（OS）和颅内无进展生存期（iPFS）。使用Cox回归模型估计预后因素的风险比（95% CI）。EGFR野生型/ALK、EGFR突变和ALK重排患者的中位OS/iPFS（95% CI）（月）分别为17.7（12.9-23.6）/12.1（9.8-15.6）、28.9（23.8-33.3）/17.7（14.8-21.2）和118.0（未达到）/71.7（15.1-未达到）。在EGFR突变患者中，将我们的数据与其他研究进行荟萃分析后发现，接受SRS和TKI治疗的患者的OS和iPFS（OS：35.1个月，iPFS：20.0个月）显著优于只接受SRS（OS：20.8个月，iPFS：11.8个月）或只接受TKI（OS：24.3个月，iPFS：13.8个月）的患者。对新诊断的脑转移进行SRS治疗并继续使用现有的TKI药物可获得与新诊断的带脑转移NSCLC患者开始联合SRS和TKI治疗相当的OS（30.0 vs. 32.1个月，p = 0.200）。多变量分析显示，良好的表现评分和TKI治疗与改善预后有关。在新诊断的带脑转移的EGFR突变NSCLC患者中，联合SRS和TKI的治疗效果良好。在出现新的脑转移时继续使用相同的TKI药物加SRS可获得良好的临床结局，可以作为标准治疗考虑。©2023年。作者（们）已独家授权给Springer Science+Business Media, LLC，属于Springer Nature的一部分。

To examine the differential effects of SRS and TKI on EGFR-mutated NSCLC patients with brain metastases (BMs) and outcomes following continuation of the same TKI agent in case of new BMs.This study included 608 NSCLC patients (2,274 BMs) while meta-analyses included 1,651 NSCLC patients (> 3,944 BMs). Overall survival (OS) and intracranial progression free survival (iPFS) were estimated using Kaplan-Meier methods. Hazard ratios (95% CI) of prognostic factors were estimated using Cox regression models.The median OS/iPFS (95% CI) (months) for patients with wildtype EGFR/ALK, EGFR mutations, and ALK rearrangements were 17.7 (12.9-23.6)/12.1 (9.8-15.6), 28.9 (23.8-33.3)/17.7 (14.8-21.2), and 118.0 (not reached)/71.7 (15.1-not reached), respectively. In EGFR-mutated patients, meta-analyses combining our data showed significantly improved OS and iPFS of patients who received SRS and TKI (OS:35.1 months, iPFS:20.0 months) when compared to those who have SRS alone (OS:20.8 months, iPFS:11.8 months) or TKI alone (OS:24.3 months, iPFS:13.8 months). Having SRS for newly diagnosed BMs while keeping the existing TKI agent yielded OS (30.0 vs. 32.1 months, p = 0.200) non-inferior to patients who started combined SRS and TKI therapy for their newly diagnosed NSCLC with BMs. Multivariable analyses showed that good performance score and TKI therapy were associated with improved outcomes.Combined SRS and TKI resulted in favorable outcomes in EGFR-mutated NSCLC patients with newly diagnosed BMs. Continuation of the same TKI agent plus SRS in case of new brain metastases yielded good clinical outcomes and may be considered a standard-of-care treatment.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.