Abstract
BackgroundBreast cancer has a poor prognosis due to the high risk of distant metastasis.PurposeTo identify the prognosticators of brain metastasis from breast cancer treated by whole-brain radiotherapy.Material and MethodsWe evaluated patients diagnosed with primary brain metastasis without carcinomatous meningitis from breast cancer and had undergone whole-brain radiotherapy as initial treatment between 1 January 2010 and 30 September 2019. We investigated associations between overall survival time from diagnosis using cranial contrast-enhanced magnetic resonance imaging (MRI)/computed tomography (CT) and the following parameters: (i) age; (ii) sex; (iii) time to appearance of brain metastasis; (iv) other metastasis at appearance of brain metastasis; (v) blood test; (vi) symptoms at time of brain metastasis; (vii) whole-brain radiotherapy dose; (viii) whether whole-brain radiotherapy was completed; (ix) course of chemo- or radiotherapy; (x) subtype; (xi) additional irradiation after whole-brain radiotherapy; (xii) pathology; and (xiii) imaging findings.ResultsWe evaluated 29 consecutive female patients (mean age 55.2 ± 12.1 years). Median overall survival time after diagnosis on cranial contrast-enhanced MRI/CT was 135 days (range 16–2112 days). Multivariate stepwise analysis of the three parameters of lactate dehydrogenase, dose, and subtype identified the following significant differences: Hazard Ratio (HR) for dose (discontinued, 30 Gy/10 fractions, 31.5 Gy/11 fractions, 32.5 Gy/11 fractions, 37.5 Gy/15 fractions) was 0.08 (95% confidence interval [CI] 0.02–0.30, P < 0.01), and HR for subtype (luminal, HER2, triple-negative) was 2.70 (95% CI 1.16–6.243, P < 0.01).ConclusionHER2-type and 37.5 Gy/15 fractions are good prognostic factor after whole-brain radiotherapy in breast cancer with brain metastases.
Highlights
Breast cancer is the most common malignant tumor among Japanese women [1]
We investigated associations between overall survival (OS) time and: (i) age; (ii) sex; (iii) time to appearance of brain metastasis; (iv) stage at initial examination; (v) other metastasis on identification of brain metastasis; (vi) blood test results 1⁄4 white blood cell count (WBC), red blood cell count (RBC), platelets, total protein, albumin, lactate dehydrogenase (LDH); C-reactive protein (CRP), carcinoembryonic antigen (CEA), and carbohydrate antigen 15-3 (CA15-3); (vii) symptoms at time of identification of brain metastasis; (viii) whether wholebrain radiotherapy was completed; (ix) course of chemo- or radiotherapy; (x) subtype; (xi) additional irradiation after whole-brain radiotherapy; (xii) pathology; and (xiii) imaging findings
We enrolled 54 patients; the progress of 15 patients was not clear, the number of brain metastases could not be evaluated in three patients, and seven patients had a low number of brain metastases ( 4)
Summary
In around 25% of cases, patients with breast cancer develop brain metastases [2]. In patients with a single brain metastasis, the addition of whole-brain radiotherapy to stereotactic radiotherapy has been found to prolong time of overall survival (OS) [3]. In patients with two or three metastases, addition of whole-brain radiotherapy to stereotactic radiotherapy appears to have no effect on prolonging time of OS [3]. Purpose: To identify the prognosticators of brain metastasis from breast cancer treated by whole-brain radiotherapy. Material and Methods: We evaluated patients diagnosed with primary brain metastasis without carcinomatous meningitis from breast cancer and had undergone whole-brain radiotherapy as initial treatment between 1 January 2010 and 30 September 2019. Conclusion: HER2-type and 37.5 Gy/15 fractions are good prognostic factor after whole-brain radiotherapy in breast cancer with brain metastases
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
