Identification of patients who may benefit from the prophylactic cranial radiotherapy among breast cancer patients with brain metastasis

Saip, Pınar; Çiçin, İrfan; Eralp, Yeşim; Karagöl, Hakan; Küçücük, Seden; Alas, Ruşen Çoşar; Yavuz, Ekrem; Dincer, Maktav; Sağlam, Esra; Topuz, Erkan

doi:10.1007/s11060-008-9769-0

Cited by 19 publications

(33 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with TNC in our study also had 1.8 times more risk of developing brain metastasis. It had been reported that TNC patients had shorter survival after diagnosing brain metastasis when compared to non TNC counterparts and hence is a poor prognostic indicator (Saip et al, 2009). Consistent with findings reported in Western population (Rodriguez-Pinilla et al, 2006;Dent et al, 2009), we did not find any difference between the TNC and non TNC groups in incidence of bone metastasis.…”

Section: Discussionsupporting

confidence: 91%

Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

Chau²,

Wong³

et al. 2012

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 91%

Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

Chau²,

Wong³

et al. 2012

Asian Pacific Journal of Cancer Prevention

View full text Add to dashboard Cite

“…Once brain metastases are diagnosed the survival is usually poor. Reported median survival rates of breast cancer patients with brain metastasis are usually in the range of 3 to 8 months [9,14,16,17,32]. Prophylactic cranial irradiation has been shown to effectively reduce the frequency of brain metastases and to improve the survival in lung cancer [33-35].…”

Section: Discussionmentioning

confidence: 99%

Identification of breast cancer patients with a high risk of developing brain metastases: a single-institutional retrospective analysis

et al. 2014

View full text Add to dashboard Cite

BackgroundThe objective of this study was to identify breast cancer patients with a high risk of developing brain metastases who may benefit from pre-emptive medical intervention.MethodsMedical records of 352 breast cancer patients with local or locoregional disease at diagnosis were retrospectively analysed. The brain metastasis-free survival was estimated using the Kaplan-Meier method and patient groups were compared using the log rank test. The simultaneous relationship of multiple prognostic factors was assessed using Cox’s proportional hazard regression analysis. The Fisher exact test was used to test the difference of proportions for statistical significance.ResultsOn univariate analysis, statistically highly significant unfavourable risk factors for the brain metastasis-free survival were negative ER status, negative PR status, and triple negative tumor subtype. Young age at diagnosis (≤35 years) and advanced disease stage were not statistically significant (p = 0.10). On multivariate analysis, the only independent significant factor was the ER status (negative ER status; hazard radio (95% confidence interval), 5.1 (1.8-14.6); p = 0.003). In the subgroup of 168 patients with a minimum follow-up of 24 months, 49 patients developed extracranial metastases as first metastatic event. Of those, 7 of 15 (46.6%) with a negative ER status developed brain metastases compared to 5 of 34 (14.7%) with a positive ER status (Fisher exact test, p = 0.03). The median time interval (minimum-maximum) between the diagnosis of extracranial and brain metastases was 7.5 months (1-30 months).ConclusionsBreast cancer patients with extracranial metastasis and negative ER status exhibited an almost 50% risk of developing brain metastasis during their course of disease. Future studies are highly desired to evaluate the efficacy of pre-emptive medical intervention such as prophylactic treatment or diagnostic screening for high risk breast cancer patients.

show abstract

“…A number of patient and tumor characteristics, including younger age (premenopausal or \50 years) [17], the presence of lung or liver metastases [17], negative hormonereceptor (HR) status [18], larger tumor size [19,20], larger number of involved lymph nodes [20,21], and positivity for human epidermal growth factor receptor 2 (HER2) [19,22], have been identified as risk factors for developing BM [18,20,21,[23][24][25]. Regarding the relationship between HER2 status and the incidence of BM, patients with HER2-positive breast cancer are at risk of developing BM, with cumulative incidence as high as 30-50% [17,22,24,26,27].…”

Section: Risk Factors Of Developing Bm Among Patients With Breast Cancermentioning

confidence: 99%

Radiation therapy for brain metastases in breast cancer patients

Aoyama

2010

Breast Cancer

View full text Add to dashboard Cite

Most randomized comparison trials (RCTs) investigating treatments for brain metastases (BM) have included BM from any origin; as a result, more than half (52.4-77.0%) of the BM in these trials originated from the lungs (mostly non-small-cell lung cancer, NSCLC), with the breasts being the origin in only 6.8-19.0% of cases. In addition, patients with poor systemic status (KPS \ 70) were not included in these trials. Hence, before we can apply RCT-based information to the daily clinical treatment of BM from breast cancers, it will be crucial to differentiate the characteristics of BM originating from NSCLC and BM originating from breast cancer. Although stereotactic radiosurgery (SRS) is widely used in Japan, level-1 evidence suggests that the benefit of using SRS in addition to whole-brain radiation therapy (WBRT) has been proven only for patients with a single BM. Treatment with SRS alone, which is widely used in Japan, seems attractive because it could avoid the risk of long-term adverse effects of WBRT. However, level-1 evidence suggests that the omission of WBRT results in a high frequency of brain tumor recurrence (BTR). In an RCT between SRS-alone and SRS ? WBRT conducted in Japan, we found that patients who had a single BM and no extracranial metastases had a low risk of developing BTR after initial brain management (low-risk group) compared with those who had 2 or more BM and extracranial metastases (high-risk group). In order to meet the criteria of ''low-risk'' BTR, patients also should have good systemic status (KPS 3 70). Epidemiologic data suggest that the prognosis is twice as likely to be poor in patients with BM from breast cancer (RPA III = KPS \ 70) than in patients with BM from NSCLC (40 vs. 20%); in addition, the probability of brain-only metastases in patients with breast cancer is less than half that in patients with NSCLC (20-25 vs. 60-75%). Considering these findings, we should be aware that most patients with BM from breast cancer are not good candidates for SRS alone, and, therefore, the role of WBRT is still important in the era of modern radiation techniques.

show abstract

Identification of patients who may benefit from the prophylactic cranial radiotherapy among breast cancer patients with brain metastasis

Cited by 19 publications

References 28 publications

Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

Triple Negative Status is a Poor Prognostic Indicator in Chinese Women with Breast Cancer: a Ten Year Review

Identification of breast cancer patients with a high risk of developing brain metastases: a single-institutional retrospective analysis

Radiation therapy for brain metastases in breast cancer patients

Contact Info

Product

Resources

About