Whole brain radiotherapy results of patients with brain metastases and investigation of their prognostic factors

Aims: Metastatic brain tumors are the most commonly seen intracranial lesion in adults and an important cause of morbidity and mortality in patients with cancer. This study aimed to evaluate the postoperative mortality, morbidity, and survival rates of patients who underwent surgery in our clinic for metastatic brain tumorsMethod: Clinical data of 131 patients, including age, sex, symptoms, localization, primer site, surgical methods, resection, complications and recurrence were collected.Results: Fifty patients (38.1%) were female, and 81 (61.8%) patients were male. The average age of the patients was 54,9. The most common reason for hospital admission was headache (68.7%). Lesions were detected in the cerebral hemisphere in 108 (82.4%) patients and the posterior fossa in 23 (17.5%) patients, and 16 (12.2%) patients had multiple lesions. All patients (n=131) underwent surgery with neuronavigation. Total resection was performed in 25 (19%) patients, gross total resection in 83 (63.3%), subtotal resection in 18 (13.7%), and biopsy in 5 (3.8%). The most commonly seen tumor originated from the lungs (n=63, 48%), according to the histopathological examination. The mean overall survival was 5.3 (range, 1–36) months during the follow-up period. Twelve (9.1%) patients had recurrence and underwent surgery again.Conclusion: Multidisciplinary treatment methods are used in the treatment of metastatic brain tumors. Effective surgical intervention to eliminate peritumoral edema and increased intracranial pressure improves postoperative survival rates. In addition, post-surgical whole-brain radiotherapy reduces recurrence and improves survival.

show abstract

“…Brain metastases are most commonly detected between ages 50 and 70 years (40) . In this study, the mean patient age was 54.9 years.…”

Section: Discussionmentioning

confidence: 99%

Surgical Management and Postoperative Outcome in patients with Brain Metastases: Our Surgical Experience

Doğan

Durmaz²,

Gezgin

et al. 2022

Sinir Sistemi Cerrahisi Derg

View full text Add to dashboard Cite

show abstract

“…However, some cases of tumor types such gastro-oesophageal cancers, genitourinary cancers, head and neck cancers and sarcomas are rarely lead to BM. In 2700 cases from the Memorial Sloan-Kettering Cancer Center in New York, Victor et al reported that the distribution of primary cancers was as follows: 48% lung, 15% breast, 9% melanoma, 1% lymphoma, 3% gastrointestinal, 11% genitourinary, 10% osteosarcoma, 5% neuroblastoma and 6% head and neck cancer [11]. The prognosis of patients with brain metastases is generally poor, and survival is about 4 weeks, if untreated [12].…”

Section: Discussionmentioning

confidence: 99%

Combination toripalimab and bevacizumab for an elderly urothelial carcinoma patient with brain metastasis who failed rapidly after radiotherapy: a case report and literature review

Yan

Wang

2022

Anti-Cancer Drugs

View full text Add to dashboard Cite

Brain metastasis is a rare refractory event in patients with urothelial carcinoma. Platinum-based chemotherapy is the recommended first-line standard therapy for all metastasis urothelial carcinoma patients eligible for cisplatin or carboplatin. Patients ineligible for platinum may receive immunotherapy. No clear evidence exists that UC with brain metastasis is sensitive to immunotherapy, and the optimal treatment for patients with BM is uncertain. We evaluated the safety and efficacy of combined immunotherapy and antivascular therapy in an elderly patient with urothelial carcinoma with brain metastasis, and summarize the currently available evidence. First, she underwent a left nephrectomy and left ureterectomy and recovered well postoperatively. The postoperative pathologic findings were consistent with urothelial carcinoma. Approximately 2 years later, the patient developed impaired limb movement on the right side and underwent MRI, which revealed lesions in the left frontal lobe and suggested brain metastasis. The brain metastasis responded to local radiotherapy but progressed again in a short time. Then, the patient was administered toripalimab at 240 mg combined with bevacizumab at 300 mg every 3 weeks. After 1cycle of treatment, the patient achieved a quick response, and symptoms improved significantly. Repeat evaluation imaging demonstrated that the lesions in the brain and lung were significantly smaller and evaluation showed partial response. The treatment was well tolerated and the patient remained in partial response until the last follow-up by July 2022, 6 months after the initiation of treatment. This case suggests that immune checkpoint blockade combined with antivascular therapy might be a new possibility for patients with metastatic urothelial carcinoma, including brain metastases.

show abstract

Whole brain radiotherapy results of patients with brain metastases and investigation of their prognostic factors

Cited by 2 publications

References 22 publications

Surgical Management and Postoperative Outcome in patients with Brain Metastases: Our Surgical Experience

Surgical Management and Postoperative Outcome in patients with Brain Metastases: Our Surgical Experience

Combination toripalimab and bevacizumab for an elderly urothelial carcinoma patient with brain metastasis who failed rapidly after radiotherapy: a case report and literature review

Contact Info

Product

Resources

About