Use of radiotherapy in breast cancer patients with brain metastases: a retrospective 11-year single center study

Abstract

Aim: To analyse the use of radiotherapy (RT) and factors affecting overall survival (OS) after RT in breast cancer patients with brain metastases.Methods: Breast cancer patients treated from 2008 to 2018 with whole brain RT (WBRT) or stereotactic radiosurgery (SRS) at a large regional cancer referral center were identified from the hospital's RT register. Clinical variables were extracted from medical records. OS was calculated from date of first RT until death or last follow up. Potential factors affecting OS were analyzed.Results: 255 females with WBRT (n ¼ 206) or SRS (n ¼ 49) as first RT were included. An increased use of initial SRS was observed in the second half of the study period. The most common WBRT fractionation regimen was 3 Gy  10. SRS was most often single fractions; 18 or 25 Gy between 2009 and 2016, while fractionated SRS was mostly used in 2017 and 2018. Median OS in the WBRT group was 6 months (CI 1-73) relative to 23 (CI 0-78) in the SRS group. Age, performance status, initial RT technique, extracranial disease, brain metastasis surgery, number of brain metastases and DS-GPA score had significant impact on OS. Only ECOG 0 and brain metastasis surgery were associated with superior OS in multivariate analysis. Conclusion:WBRT was the most frequent primary RT. An increased use of initial SRS was observed in the second half of the study period. Only ECOG 0 and brain metastasis surgery were associated with superior OS in multivariate analysis.R ESUM E But : Analyser l'utilisation de la radioth erapie (RT) et les facteurs affectant la survie globale (SG) apr es la RT chez les patientes atteintes d'un cancer du sein avec m etastases au cerveau.Contributors: All authors contributed to the conception or design of the work, the acquisition, analysis, or interpretation of the data. All authors were involved in drafting and commenting on the paper and have approved the final version.

The Pattern of Care for Brain Metastasis from Breast Cancer over the Past 10 Years in Korea: A Multicenter Retrospective Study (KROG 16-12)

“…This was observed especially in patients with 1–4 BM and over half of these patients in 2014 were treated with SRS/FSRT alone. These findings coincide with previous reports [ 19 , 23 , 24 ]. Several factors have affected this paradigm shift in initial approaches for BM.…”

A network meta-analysis of curative effect of different treatment methods on patients with brain metastasis of breast cancer

“…After reading the title and abstract, 33 studies were obtained by excluding irrelevant studies, noncontrolled experimental studies, conferences, abstracts, meta-analyses, and others. For the remaining ones, after reading the full text, 14 were finally included, [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] with a total of 1723 patients(see Fig. 1).…”

CSCO expert consensus on the diagnosis and treatment of breast cancer brain metastasis

“…Although the indications for WBRT are continually challenged by SRT ( 53 ). WBRT remains an appropriate and optional treatment for patients with diffuse BMs with or without leptomeningeal involvement.…”