Clinical outcomes in patients with brain metastases from breast cancer treated with single-session radiosurgery or whole brain radiotherapy
| Autor: | Michael Mix, Dheerendra Prasad, Robert J. Plunkett, Tracey O'Connor, Rania Elmarzouky |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Breast Neoplasms Radiosurgery Metastatic tumor 03 medical and health sciences 0302 clinical medicine Breast cancer medicine Humans In patient Estrogen Receptor Status Retrospective Studies Brain Neoplasms business.industry Whole brain radiotherapy General Medicine Middle Aged medicine.disease Tumor registry Surgery Treatment Outcome 030220 oncology & carcinogenesis Female Radiology Cranial Irradiation business Single session 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurosurgery. 125:26-30 |
| ISSN: | 1933-0693 0022-3085 |
| DOI: | 10.3171/2016.7.gks161541 |
| Popis: | OBJECTIVEGamma Knife radiosurgery (GKRS) is used to treat brain metastases from breast cancer (BMB) as the sole treatment or in conjunction with tumor resection and/or whole brain radiotherapy (WBRT). This study evaluates outcomes in BMB based on treatment techniques and tumor biological features.METHODSThe authors reviewed all patients treated with BMB between 2004 and 2014. Patients were identified from a prospectively collected radiosurgery database and institutional tumor registry; 214 patients were identified. Data were collected from aforementioned sources and supplemented with chart review where needed. Independent radiological review was performed for all available brain imaging in those treated with GKRS. Survival analyses are reported using Kaplan-Meier estimates.RESULTSDuring the 10-year study period, 214 patients with BMB were treated; 23% underwent GKRS alone, 46% underwent a combination of GKRS and WBRT, and 31% underwent WBRT alone. Median survival after diagnosis of BMB in those treated with GKRS alone was 21 months, and in those who received WBRT alone it was 3 months. In those treated with GKRS plus WBRT, no significant difference in median survival was observed between those receiving WBRT upfront or in a salvage setting following GKRS (19 months vs 14 months, p = 0.63). The median survival of patients with total metastatic tumor volume of ≤ 7 cm3 versus > 7 cm3 was 20 months vs 7 months (p < 0.001). Human epidermal growth factor receptor-2 (Her-2) positively impacted survival after diagnosis of BMB (19 months vs 12 months, p = 0.03). Estrogen receptor status did not influence survival after diagnosis of BMB. No difference was observed in survival after diagnosis of BMB based on receptor status in those who received WBRT alone.CONCLUSIONSIn this single-institution series of BMB, the addition of WBRT to GKRS did not significantly influence survival, nor did the number of lesions treated with GKRS. Survival after the diagnosis of BMB was most strongly affected by Her-2 positivity and total metastatic tumor volume. |
| Databáze: | OpenAIRE |
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