Outcome of older patients with breast cancer with brain metastases.

Abstract

e11501 Background: 60% of new cancers are diagnosed in patients aged 65 years and over. 20 to 40% of people treated for metastatic breast cancer will develop brain metastases. Methods: The aim of this retrospective study, performed in 2 French cancer centers, Institut Curie and Centre Rene Huguenin, was to describe clinical aspects of older breast cancer patients with brain metastases, discussing the various treatment options, their tolerance and efficacy in this specific population treated between 1998 and 2008. Results: Demographic data, tumor characteristics, metastatic sites and treatment of 95 patients were prospectively recorded. The median patient age was 70 years [65-87]. 19 patients (20%) were 75 years old or over. Median ECOG performans status was 2. 85 patients (89%) received radiotherapy. 5 major side effects required to stop the treatment (2 focal neurological deficiency and 3 deliriums). 58 patients (61.5%) received a systemic treatment. 6 chemotherapy treatments and 2 targeted therapies were stopped because of side effects. Hormonotherapy has been well tolerated. No toxic death occurred. The overall median survival was 4 months. Median survival of patients who did not receive any treatment was 1 month versus 5 months when at least one treatment was given (p<0.004). Median survival was 5 months with radiotherapy versus 1 month without (p<0.004), 9 months with chemotherapy versus 2 months without (p<0.0001) and 8 months with hormonotherapy versus 3 months without (p<0.0009). Unfortunately, no geriatric data were available because of some patients were treated ten years ago. Only 2 patients wished not to be treated. Conclusions: The different treatments received appear safe. Median survival in older patients with breast cancer treated for brain metastases is comparable as median survival described in studies including young patients. Despite their age, patients wish to receive a treatment and are susceptible to benefit from it. No significant financial relationships to disclose.