ObjectiveTo investigate the effect of simultaneous integrated boost image-guided radiation therapy (SIB-IGRT) combined with icotinib in the treatment of epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma brain metastases. MethodsA total of 70 patients with EGFR-mutant lung adenocarcinoma brain metastases were enrolled, and they were divided into synchronous treatment group and radiotherapy-first group according to the random number table method, with 35 cases in each group. The SIB-IGRT was performed in the synchronous treatment group on the first day of icotinib targeted therapy, while the SIB-IGRT was performed in the radiotherapy-first group 15 days before icotinib targeted therapy. The short-term efficacy ［disease control rate (DCR), objective response rate (ORR)］, long-term efficacy ［progression-free survival (PFS)］, and incidence of adverse reactions were compared between the two groups. Results(1) The ORR and DCR were higher and the PFS was longer in the synchronous treatment group than those in the radiotherapy-first group (all P＜0.05). The incidences of nausea, vomiting, and fatigue were lower in the synchronous treatment group than those in the radiotherapy-first group (all P＜0.05). ConclusionSynchronous treatment of SIB-IGRT combined with icotinib can improve the DCR and ORR of patients with EGFR-mutant lung adenocarcinoma brain metastases and prolong the PFS of patients with less adverse reactions, which is worthy of clinical promotion and application.

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