Prognostic factors affecting the outcome of brain metastases from breast cancer

Liu, Mu-Tai; Hsieh, Chang‐Yao; Wang, Ai-Yih; Chang, Tse Wen; Pi, Chu-Pin; Huang, Chia‐Wei; Huang, Chao-Yuan; Liou, Cheng-Hong

doi:10.1007/s00520-006-0029-6

Cited by 17 publications

(13 citation statements)

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“…In the present cohort, surgical resection was typically performed in patients with a solitary brain metastasis. It is well established that a smaller number of BM is associated with longer survival (7,14,15,23). In the present cohort, the group of patients that underwent surgical resection was very small.…”

Section: Discussionmentioning

confidence: 66%

Radiotherapy of brain metastases from breast cancer: Treatment results and prognostic factors

Kühnöl

Vordermark

2016

Oncology Letters

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Abstract. Brain metastases (BM) from breast cancer are associated with high morbidity and a poor prognosis. The aim of this study was to analyse the role of radiotherapy in treatment of BM from breast cancer in the context of modern local therapy modalities, current systemic treatment options and prognostic factors. A retrospective analysis of 86 consecutive female patients treated with radiotherapy for BM from breast cancer between 2000 and 2010 was conducted. Patient and treatment characteristics were registered and survival data calculated. All patients received whole-brain radiotherapy (WBRT) with a median dose of 36 Gy, and 19 patients were treated with an additional boost; this included fractionated schemes (median dose, 18 Gy) and radiosurgery (5 and 17 Gy). The median overall survival time from the start of WBRT was 4.1 months in the present cohort. Patients receiving a boost survived 19.7 months in comparison to 3.1 months for patients treated with WBRT alone (P<0.001). Other factors that improved overall survival, based on a univariate analysis, were dose of WBRT and number of BM. There was no statistical evidence for the influence of the human epidermal growth factor receptor 2 status on survival in the current study. The administration of boost treatment following WBRT was also identified as a significant factor influencing survival on multivariate analysis (P=0.030). In conclusion, radiotherapy affects the survival time of patients with BM from breast cancer. In particular, the implementation of boost treatment following WBRT in selected patients seems to extend survival time. IntroductionThe most common brain tumours are intracranial metastases (1). Over 20% of patients with solid malignant tumours develop brain metastases (BM); patients with small-cell lung cancer (45%), melanomas (45%), non-small-cell lung cancer (30%), breast cancer and renal cancer (20%) have the highest risk for the occurrence of intracranial metastases (2). The incidence of clinically detected BM in patients with metastatic breast cancer is 16-20%, and autopsy studies suggest a prevalence of BM of up to 34% (3-6). A number of risk factors for cerebral metastases in breast cancer patients have been reported in the literature; in addition to young age (<35 years), large primary tumour size (>2 cm)and negative estrogen receptor (ER) status, the overexpression of human epidermal growth factor receptor 2 (HER2) has been demonstrated to be associated with a higher risk of BM (7-10).The management of BM includes radiotherapeutic, surgical and medical options. Consideration of a local treatment modality depends on the number of intracranial metastases and potential local complications resulting from their location and size. Patients with multiple BM typically receive whole-brain radiotherapy (WBRT), whilst neurosurgery or stereotactic radiosurgery (SRS) are possible treatment options for patients with a single BM. The application of intrathecal chemotherapy may be selected as the therapeutic regime in cases with meningeal involvement...

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Section: Discussionmentioning

confidence: 66%

Radiotherapy of brain metastases from breast cancer: Treatment results and prognostic factors

Kühnöl

Vordermark

2016

Oncology Letters

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“…In order to improve survival, the enrollment of more patients with brain metastases from breast cancer for prospective trials involving multimodality approach, which combines radiation and systemic therapies based on appropriate patient triage, is warranted [2].…”

Section: Prognostic Factors Affecting the Outcome Of Brain Metastasesmentioning

confidence: 99%

Prognostic factors affecting the outcome of brain metastases from breast cancer

Liu

Hsieh

Wang

et al. 2006

Support Care Cancer

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single metastatic lesion of the brain, and brain metastases as a site of first metastases had significantly better survival in univariate analysis. Only the age during diagnosis and estrogen receptor (ER) were significantly associated with overall survival in the multivariate analysis. Patients with ER-positive disease tended to have longer overall survival compared to patients with ER-negative disease (p=0.003). Patients of 50 years of age or less tended to have longer overall survival compared to patients of more than 50 years of age (p=0.047).We thank Dr. Altundag for his constructive comments. Initially, we did not include hormone receptor status in predicting survival rate. We evaluate ER status as a predictor for survival at present. In univariate analysis, patients with positive ER status had significantly better survival (p<0.0001). However, only the Karnofsky performance status and the number of brain metastases were statistically significant for overall survival in multivariate analysis.In order to improve survival, the enrollment of more patients with brain metastases from breast cancer for prospective trials involving multimodality approach, which combines radiation and systemic therapies based on appropriate patient triage, is warranted [2]. References1. Altundag K, Bondy ML, Kau SW, Broglio K, Rivera E (2005) Clinicopathologic characteristics and prognostic factors in 420 metastatic breast cancer patients with central nervous system metastases. Breast Cancer Res Treat 94(Suppl 1):S143 (Abstract 3056) 2. Liu MT, Hsieh CY, Wang AY, Chang TH, Pi CP, Huang CC, Huang CY, Liou CH (2006) Prognostic factors affecting the outcome of brain metastases from breast cancer. Support Care Cancer 14:936-942

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“…Le caractè re unique a un impact pronostique favorable [164,291]. La mé diane de survie est d'environ 15 mois.…”

Section: Situations Cliniquesunclassified

Cancer du sein métastatique

2009

Oncologie

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Prognostic factors affecting the outcome of brain metastases from breast cancer

Cited by 17 publications

References 47 publications

Radiotherapy of brain metastases from breast cancer: Treatment results and prognostic factors

Radiotherapy of brain metastases from breast cancer: Treatment results and prognostic factors

Prognostic factors affecting the outcome of brain metastases from breast cancer

Cancer du sein métastatique

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