Brain metastasis from colorectal cancer: Treatment, survival, and prognosis

Li, Wenxia; Wang, Tongsheng; Zhu, Yubing; Hai-jiao, YU; Ma, Ling; Ding, Yuhan; Gao, Hong; Ding, Lei

doi:10.1097/md.0000000000030273

Cited by 8 publications

(12 citation statements)

References 36 publications

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“…Similarly, Nozawa et al and Thompson et al showed that lung and bone metastases were independent predictive factors for BM in CRC [2,14]. In addition, previous studies have reported that the median interval from lung metastasis to BM was 8-11 months, the median interval from liver metastasis to BM was 6.5 months, and the median interval from bone metastasis to BM was 3 months [22,23]. We found that the median time interval from liver metastasis to BMs was 8 months.…”

Section: Discussionmentioning

confidence: 93%

Patients with brain metastasis from colorectal cancer

Yang

Wang

et al. 2023

Preprint

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Background This study aimed to retrospectively evaluate the treatment strategies and possible prognostic factors in patients with brain metastases (BMs) from colorectal cancers (CRC). Methods We retrospectively reviewed 40 patients with BMs from CRC who were treated at our center between July 2011 and May 2022. Clinicopathological characteristics and clinical outcomes were analyzed. Results The median follow-up time was 3 (range, 0.5–28) months. The median survival time after diagnosis of BMs was 4 months. The 1-year survival rate was 9.5%. In the univariate analysis, the absence of extracranial metastases was significantly associated with better overall survival (OS) but not intracranial progression-free survival (iPFS), while Eastern Cooperative Oncology Group performance status, recursive partitioning analysis (RPA) classification and local treatment of BMs were significantly associated with iPFS and OS. Multivariate analysis showed that only local treatment of BMs influenced the iPFS and OS. In addition, the OS was better in patients with intracranial benefit. The median time interval between the diagnosis of the primary tumor and BMs was 28 (range, 2–107) months. Among these BMs, 16.2% of the BM occurred within the first year after diagnosis of the primary tumor, 43.2% in the first 2 years, and 67.6% in the first 3 years. Conclusions local treatment of BMs was an independent prognostic factor for patients with BMs from CRC. Earlier detection followed by an aggressive local therapeutic approach for BMs had a great influence on treatment outcomes as well as the long-term prognosis and quality of life.

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Section: Discussionmentioning

confidence: 93%

Patients with brain metastasis from colorectal cancer

Yang

Wang

et al. 2023

Preprint

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“…Nevertheless, with increased utilization of brain imaging, the incidence of brain metastases from CRC continues to increase. Hence, finding effective treatments for BM from CRC is of paramount importance [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Historically, the utilization of systemic therapy in patients with BMs has been limited by the presence of the blood–brain barrier (BBB), which restricts the entry of hydrophilic and/or large drugs into the brain.) [ 5 , 12 , 19 , 20 ]. Another consideration that might explain the disappointing results of chemotherapy in BM is the fact that metastatic cells in the brain often develop late in the course of the disease; after several rounds of prior chemotherapy for the systemic disease, allowing for the development of resistance through the accumulation of various mutations [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

“…The crude incidence of BM from CRC is 0.27%. However, with advances in diagnostics and treatment techniques, the reported incidence increases to 9% [ 5 ]. Brain metastases are believed to occur by seeding of circulating tumor cells into the brain microvasculature; within this special microenvironment, tumor growth is encouraged and the penetration of systemic medical therapies is limited, this has been demonstrated in both clinical and preclinical studies [ 6–10 ].…”

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confidence: 99%

“…The traditional treatment of BM from CRC has been radiotherapy which continues to be the main modality of treatment [ 5 , 12 , 13 ].…”

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confidence: 99%

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Cetuximab plus XELOX show efficacy against brain metastasis from colorectal cancer: a case report

et al. 2023

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Brain metastasis (BM) from colorectal cancer (CRC) is rare and associated with poor prognosis. The mainstay of treatment for BM from CRC is radiotherapy, systemic treatment options for CRC can include novel targeted agents, conventional chemotherapy or a combination of both. Nevertheless, the efficacy of these systemic treatment options against BM from CRC is not yet fully established. Cetuximab, a monoclonal antibody, has been shown to be effective in patients with KRAS wild-type metastatic CRC. The combination of cetuximab with oxaliplatin-based chemotherapy is commonly utilized as a systemic treatment for metastatic CRC. Hereby, we report a case of BM from CRC with significant response after capecitabine and oxaliplatin (XELOX) combined with cetuximab.

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Clinical features and prognostic factors of brain metastases from colorectal cancer: a single center experience

Zhao

Jin

2023

Int J Colorectal Dis

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Purpose: The study aimed to investigate the clinical characteristics, prognostic factors, survival times, and therapy outcomes of brain metastases (BM) from colorectal cancer (CRC).Methods: The clinical characteristics of 25 patients with BM from CRC were retrospectively analyzed. The time of the occurrence of BM after diagnosis of CRC was recorded. Meanwhile, the time from the occurrence of lung, bone, liver, and other extracranial metastases to the occurrence of BM was also recorded. We evaluate the time factors affecting the length of the occurrence of BM and the potential prognostic factors after BM diagnosis. The in uences of patients undergoing surgery-based comprehensive treatment, radiotherapy-based comprehensive treatment, and co-medication were also assessed.Results: In patients with BM from CRC, lung metastases (13/25) occurred at a higher frequency than liver metastases (8/25) and bone metastases (6/25). The median time to the development of BM was much shorter (3.7 vs. 25.3 months, p=0.027), with the brain being the origin site for the metastasis. The median overall survival reached 9.9 months. The interval between diagnosis of BM and bone, liver, and lung metastasis remains 3, 6.5, and 11 months, respectively. The brain lesions of patients with BM alone had higher rates in supratentorial (88.9%), while those with extracranial metastasis had a 62.5% incidence of infratentorial metastasis. The difference was statistically signi cant (p<0.05). The time of occurrence of BM in patients aged 67 years and younger was 16.1 and 30.1 months, respectively. The differences between them were statistically signi cant (p=0.043). The BM time for left-and right-sided colon cancer were 26.5 and 7.8 months, representing a statistically signi cant difference (p=0.015). The time to onset of BM for patients with and without the resection of primary lesions was 25.4 and 4.5 months.Statistically signi cant differences are shown (p=0.007). Univariate analysis demonstrated that the prognosis of patients was related to the KPS score, the number of BM, treatment methods, and the occurrence of lung metastasis (p<0.05). The multivariate analysis revealed that the treatment modality and lung metastasis were independent prognostic factors for CRC patients with BM. Right-sided CRC patients with BM have poor prognosis (8.1vs10.2months, p=0.31). Although median survival time was not signi cantly different between patients with and without bevacizumab combination therapy, bevacizumab therapy is associated with a better survival time (9.9 vs. 7.1 months, p = 0.27).Conclusion: Patients with left-sided CRC, especially those with lung metastases, are prone to brain metastases, and patients with brain metastases as the rst metastatic site have a higher rate of supratentorial metastases. Young patients with right hemicolon cancer, and patients who have not undergone primary lesion resection have a shorter time for the occurrence of BM. Patients with colorectal lung metastases, especially those young with right-sided CRC, require close imagi...

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Brain metastasis from colorectal cancer: Treatment, survival, and prognosis

Cited by 8 publications

References 36 publications

Patients with brain metastasis from colorectal cancer

Patients with brain metastasis from colorectal cancer

Cetuximab plus XELOX show efficacy against brain metastasis from colorectal cancer: a case report

Clinical features and prognostic factors of brain metastases from colorectal cancer: a single center experience

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