Prognostic impact of platinum sensitivity in ovarian carcinoma patients with brain metastasis

Autor: Natasha Carvalho Pandolfi, Fabrício de Souza Castro, Glauco Baiocchi, Andrea Paiva Gadelha Guimarães, Joyce Maria Lisboa Maya, Adriana Regina Gonçalves Ribeiro, Alexandre Andre Balieiro Anastacio da Costa, Marcelle Goldner Cesca, Ronaldo Pereira Souza, Michael Jenwel Chen, Paulo Issamu Sanematsu, Louise De Brot, Solange Moraes Sanches, João Paulo da Nogueira Silveira Lima, Graziele Bonvolim, Deborah Porto Cotrim, Elizabeth Santana dos Santos, Henrique Mantoan
Rok vydání: 2019
Předmět:
0301 basic medicine
Oncology
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Antineoplastic Agents
Platinum Compounds
Prognostic factors
lcsh:RC254-282
Neurosurgical Procedures
03 medical and health sciences
0302 clinical medicine
Surgical oncology
Ovarian cancer
Internal medicine
Ovarian carcinoma
Genetics
medicine
Humans
Aged
Retrospective Studies
Ovarian Neoplasms
business.industry
Proportional hazards model
Brain Neoplasms
Brain metastasis
Retrospective cohort study
Middle Aged
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Prognosis
Survival Analysis
Radiation therapy
030104 developmental biology
Treatment Outcome
030220 oncology & carcinogenesis
Sample Size
Cohort
Regression Analysis
Female
Cranial Irradiation
business
Platinum sensitivity
Research Article
Zdroj: BMC Cancer
BMC Cancer, Vol 19, Iss 1, Pp 1-8 (2019)
ISSN: 1471-2407
Popis: Background Brain metastasis (BM) is a rare event in ovarian cancer patients. The current prognostic scores that have been used for other tumors do not account for specific characteristics of ovarian cancer, such as platinum sensitivity. Methods This retrospective cohort study examined patients with ovarian carcinoma and BM who were treated at a single institution from January 2007 to December 2017. Clinical data on the diagnosis of BM and follow-up were collected. Cox regression was used to evaluate prognostic factors for overall survival (OS). Results Of 560 patients, 26 presented with BM. Eight patients were treated with surgery, 15 with whole-brain radiotherapy (RT), and 5 with stereotactic RT, and 4 patients received systemic treatment at the diagnosis of BM. The median OS was 10.8 months. The following factors were associated with OS: platinum-sensitive recurrence (HR 0.34, 95% CI 0.12–0.99; p = 0.049), higher number of previous treatment lines (HR 1.57, 95% CI 1.12–2.19; p = 0.008), ECOG performance status (HR 2.52, 95% CI 1.24–5.09; p = 0.010), and longer interval from initial diagnosis to BM (p = 0.025). Notably, the number of brain metastasis, the largest tumor size, and progression outside of the CNS were not related to survival. Platinum sensitivity was not associated with any of the classic prognostic factors in brain metastasis patients such as number or size of brain metastasis or disease progression outside the CNS strengthening the hypothesis of the importance of platinum sensitivity to the prognosis of ovarian cancer patients with BM. Conclusions The factors related to the biological behavior of the ovarian cancer such as platinum sensitivity at the time of BM diagnosis, fewer number of previous treatment lines and interval from initial diagnosis were associated with survival in ovarian cancer patients with BM, while factors that are usually related to survival in BM in other cancers were not associated with survival in this cohort of ovarian cancer patients. The small number of patients did not allow us to exclude the prognostic role of these former factors that were not associated with survival in the present cohort.
Databáze: OpenAIRE
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