Central Nervous System Failure in Korean Breast Cancer Patients with HER2-Enriched Subtype: Korean Radiation Oncology Group 16-15 Multicenter Retrospective Study
| Autor: | In Ah Kim, Kyubo Kim, Hyun-Ju Kim, Won Park, Kyung Hwan Shin, Yong Bae Kim, Do Hoon Oh, Doo Ho Choi, Jiyoung Kim, Jin Ho Kim, Hyeli Park, Jinhee Kim, Sun Young Lee |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty Lymphovascular invasion medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Breast cancer Trastuzumab Internal medicine medicine Chemotherapy Radiotherapy business.industry Hazard ratio Retrospective cohort study medicine.disease ERBB2 protein Radiation therapy 030104 developmental biology Central nervous system neoplasms 030220 oncology & carcinogenesis Original Article Breast neoplasms business Mastectomy medicine.drug |
| Zdroj: | Journal of Breast Cancer |
| ISSN: | 2092-9900 1738-6756 |
| Popis: | Purpose The purpose of this study was to evaluate the risk of central nervous system (CNS) failure in Korean patients with human epidermal growth factor receptor 2 (HER2)-enriched breast cancer treated with surgery followed by postoperative radiotherapy (RT). Methods A total of 749 patients from eight institutions were enrolled in this study. All of them underwent surgery followed by postoperative RT from 2003 to 2011; 246 (32.8%) received neoadjuvant chemotherapy and 649 (81.7%) received adjuvant chemotherapy. Adjuvant trastuzumab was administered to 386 patients (48.6%). Results The median follow-up duration was 84 (range, 8-171) months. The 7-year disease-free and overall survival rates were 79.0% and 84.2%, respectively. On multivariate analysis, mastectomy, nodal involvement, and presence of lymphatic invasion were correlated with poor overall survival (p = 0.004, 0.022, and 0.011, respectively), whereas T stage and lymphatic invasion were associated with disease-free survival (p = 0.018 and 0.005, respectively). Regarding CNS failures, 30 brain metastases, 2 leptomeningeal metastases, and 8 brain and leptomeningeal metastases were noted. The 7-year CNS relapse-free survival rates in patients receiving and not receiving trastuzumab were 91.2% and 96.9%, respectively (p = 0.005). On multivariate analysis, the administration of adjuvant trastuzumab was the only prognostic factor in predicting a higher CNS failure rate (hazard ratio, 2.260; 95% confidence interval, 1.076-4.746; p = 0.031). Conclusion Adjuvant trastuzumab was associated with higher CNS failure rate in Korean patients with HER2-enriched breast cancer. Close monitoring and reasonable approaches such as CNS penetrating HER2 blockades combined with the current standard therapy could contribute to improving intracranial tumor control and quality of life in patients with CNS metastasis from HER2-enriched breast cancer. |
| Databáze: | OpenAIRE |
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