Risk-reduction strategies for late complications arising from brain metastases treated with radiotherapy: a narrative review

Ye, Chen'en; Handa, Pooja; Sahgal, Arjun; Lo, Simon S.; Vellayappan, Balamurugan

doi:10.21037/cco-21-121

Cited by 4 publications

(2 citation statements)

References 57 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding prognosis, median survival for patients with BM is still poor despite improved treatment options for primary tumors over the past years [ 2 – 4 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term survival in patients with brain metastases—clinical characterization of a rare scenario

Hügel,

Stöhr,

Kuhnt

et al. 2023

Strahlenther Onkol

View full text Add to dashboard Cite

Purpose This study aimed to assess clinical, treatment, and prognostic features in patients with brain metastases (BM) from solid tumors achieving long-term survival (LTS). Further, the accuracy of diagnosis-specific Graded Prognostic Assessment scores (ds-GPA) to predict LTS was evaluated. Methods Patients admitted for radiotherapy of BM between 2010 and 2020 at a large tertiary cancer center with survival of at least 3 years from diagnosis of BM were included. Patient, tumor, treatment characteristics and ds-GPA were compiled retrospectively. Results From a total of 1248 patients with BM, 61 (4.9%) survived ≥ 3 years. In 40 patients, detailed patient charts were available. Among LTS patients, median survival time from diagnosis of BM was 51.5 months. Most frequent primary tumors were lung cancer (45%), melanoma (20%), and breast cancer (17.5%). At the time of diagnosis of BM, 11/40 patients (27.5%) had oligometastatic disease. Estimated mean survival time based on ds-GPA was 19.7 months (in 8 cases estimated survival < 12 months). Resection followed by focal or whole-brain radiotherapy (WBRT) was often applied (60%), followed by primary stereotactic radiotherapy (SRT) (20%) or WBRT (20%). 80% of patients received systemic treatment, appearing particularly active in specifically altered non-small lung cancer (NSCLC), melanoma, and HER2-positive breast cancer. Karnofsky performance score (KPS) and the presence of oligometastatic disease at BM diagnosis were persisting prognostic factors in LTS patients. Conclusion In this monocentric setting reflecting daily pattern of care, LTS with BM is heterogeneous and difficult to predict. Effective local treatment and modern systemic therapies often appear crucial for LTS. The impact of concomitant diseases and frailty is not clear.

show abstract

“…Regarding prognosis, median survival for patients with BM is still poor despite improved treatment options for primary tumors over the past years [ 2 – 4 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Long-term survival in patients with brain metastases—clinical characterization of a rare scenario

Hügel,

Stöhr,

Kuhnt

et al. 2023

Strahlenther Onkol

View full text Add to dashboard Cite

show abstract

“…Despite more available treatments for BM, including surgery, stereotactic radiotherapy (SRT), whole-brain radiation therapy (WBRT), molecularly targeted therapeutics and immunotherapies, patients with BM mostly still have a poor prognosis [1,[3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy

Jeong,

Poudyal,

Klagges

et al. 2023

Cancers

View full text Add to dashboard Cite

Background: Brain metastases (BM) cause relevant morbidity and mortality in cancer patients. The presence of cerebrovascular diseases can alter the tumor microenvironment, cellular proliferation and treatment resistance. However, it is largely unknown if the presence of distinct cerebrovascular risk factors may alter the prognosis of patients with BM. Methods: Patients admitted for the radiotherapy of BM at a large tertiary cancer center were included. Patient and survival data, including cerebrovascular risk factors (diabetes mellitus (DM), smoking, arterial hypertension, peripheral arterial occlusive disease, hypercholesterolemia and smoking) were recorded. Results: 203 patients were included. Patients with DM (n = 39) had significantly shorter overall survival (OS) (HR 1.75 (1.20–2.56), p = 0.003, log-rank). Other vascular comorbidities were not associated with differences in OS. DM remained prognostically significant in the multivariate Cox regression including established prognostic factors (HR 1.92 (1.20–3.06), p = 0.006). Furthermore, subgroup analyses revealed a prognostic role of DM in patients with non-small cell lung cancer, both in univariate (HR 1.68 (0.97–2.93), p = 0.066) and multivariate analysis (HR 2.73 (1.33–5.63), p = 0.006), and a trend in melanoma patients. Conclusion: DM is associated with reduced survival in patients with BM. Further research is necessary to better understand the molecular mechanisms and therapeutic implications of this important interaction.

show abstract

Neuroprotective effect of Myrtus communis against ionizing radiation-induced brain injury: Insights from histopathological and biochemical analysis in rats

Aslan,

Alan,

Özyılmaz Yay

et al. 2024

Journal of Radiation Research and Applied Sciences

View full text Add to dashboard Cite

Risk-reduction strategies for late complications arising from brain metastases treated with radiotherapy: a narrative review

Cited by 4 publications

References 57 publications

Long-term survival in patients with brain metastases—clinical characterization of a rare scenario

Long-term survival in patients with brain metastases—clinical characterization of a rare scenario

Diabetes Mellitus Is a Strong Independent Negative Prognostic Factor in Patients with Brain Metastases Treated with Radiotherapy

Neuroprotective effect of Myrtus communis against ionizing radiation-induced brain injury: Insights from histopathological and biochemical analysis in rats

Contact Info

Product

Resources

About