[Treatment for Brain Metastases from EGFR Mutations NSCLC Patients: How Should We Choose in Clinical Practice?]

Brain metastasis of epidermal growth factor receptor (EGFR) sensitive mutations is a hot and difficult point in targeted era of non-small cell lung cancer (NSCLC) treatment, meanwhile it is also the central issue of controversy in the field of lung cancer treatment. Different results of different studies and different understanding of different disciplines, this field of treatment has been accompanied by different voices, patients without clinical symptoms can use targeted therapy first, and then start local radiotherapy with clinical symptoms or disease progression. It is a major model of the medical oncology. That is to say, taking symptoms and progress as indication and standard of local treatment intervention. In the absence of symptoms, local radiotherapy may increase patients' pain, which belongs to overtreatment. However, the perspective of radiotherapy is that brain metastases need to be treated clinically as early as possible, if not, it may affect the survival of patients. Early treatment of local lesions and increasing the depth of treatment are helpful to prolong the survival time of patients. This article refers to relevant literatures and summarizes the discussion from the perspective of pursuing the truth of disease treatment and problem solving in order to provide reference for patients' clinical practice.【中文题目：EGFR敏感突变的NSCLC脑转移患者 治疗模式之争：临床到底该如何选择？】 【中文摘要：表皮生长因子受体（epidermal growth factor receptor, EGFR）敏感突变的脑转移是靶向时代非小细胞肺癌（non-small cell lung cancer, NSCLC）治疗的热点和难点，也是当前肺癌治疗领域争论的焦点。因不同研究的不同结果以及不同学科的理解差异，这一治疗领域一直伴随着不同的声音，肿瘤内科的主导模式为没有症状的患者可以先用靶向治疗，等出现症状或者疾病进展后再行局部放疗，即以症状和进展作为局部治疗介入的指征和标准，没有症状的情况下，给予局部放疗，有可能增加患者的痛苦，属于过度治疗，而放疗学科视角则认为脑转移需要尽早处理，否则可能影响患者生存。尽早治疗局部病变，增加治疗深度，有助于达到延长患者生存时间的目的。学科之争给临床医生选择带来诸多困惑，本文参考相关文献，从追寻治疗疾病真相和解决问题的角度总结与讨论，以期为临床实践提供参考。】 【中文关键词：脑转移；表皮生长因子受体；肺肿瘤；放疗】.