Novel prognostic classification predicts overall survival of patients receiving salvage whole-brain radiotherapy for recurrent brain metastasis from breast cancer: A recursive partitioning analysis (KROG 16-12)
- 주제(키워드) Breast cancer , Brain metastasis , Whole-brain radiotherapy , Overall survival , Recursive partitioning analysis
- 주제(기타) Oncology
- 주제(기타) Obstetrics & Gynecology
- 설명문(일반) [Kim, Jae Sik; Shin, Kyung Hwan; Kim, In Ah] Seoul Natl Univ, Dept Radiat Oncol, Coll Med, Seoul, South Korea; [Kim, Kyubo; Jung, Wonguen; Kim, Kyung Su] Ewha Womans Univ, Dept Radiat Oncol, Coll Med, Seoul, South Korea; [Im, Seock-Ah] Seoul Natl Univ, Dept Internal Med, Coll Med, Seoul, South Korea; [Kim, Yong Bae; Chang, Jee Suk] Yonsei Univ, Yonsei Canc Ctr, Dept Radiat Oncol, Coll Med, Seoul, South Korea; [Choi, Doo Ho; Kim, Haeyoung] Sungkyunkwan Univ, Samsung Med Ctr, Dept Radiat Oncol, Sch Med, Seoul, South Korea; [Park, Yeon Hee] Sungkyunkwan Univ, Samsung Med Ctr, Dept Internal Med, Sch Med, Seoul, South Korea; [Kim, Dae Yong; Kim, Tae Hyun] Natl Canc Ctr, Proton Therapy Ctr, Goyang, South Korea; [Kwon, Jeanny] Chungnam Natl Univ, Dept Radiat Oncol, Coll Med, Daejeon, South Korea; [Kang, Ki Mun] Gyeongsang Natl Univ, Dept Radiat Oncol, Sch Med, Jinju, South Korea; [Kang, Ki Mun] Gyeongsang Natl Univ, Changwon Hosp, Jinju, South Korea; [Chung, Woong-Ki] Chonnam Natl Univ, Hwasun Hosp, Dept Radiat Oncol, Med Sch, Gwangju, South Korea; [Kim, Kyung Su] Dongnam Inst Radiol & Med Sci, Dept Radiat Oncol, Busan, South Korea; [Kim, In Ah] Seoul Natl Univ, Dept Radiat Oncol, Bundang Hosp, Seoul, South Korea
- 등재 SCIE, SCOPUS
- OA유형 gold, Green Published
- 발행기관 CHURCHILL LIVINGSTONE
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190783
- 본문언어 영어
- Published As https://doi.org/10.1016/j.breast.2021.11.005
- PubMed https://pubmed.ncbi.nlm.nih.gov/34814043
초록/요약
Background: To investigate outcomes of salvage whole-brain radiotherapy (WBRT) for recurrent brain metastases (BM) from breast cancer (BC), to identify prognostic factors of overall survival (OS), and to propose a novel prognostic classification for OS in these patients. Materials and methods: We identified 54 patients who had received salvage WBRT as the second brain-focused treatment for recurrent BM from BC (2000-2014). The median follow-up duration was 4.9 months. A recursive partitioning analysis (RPA) was conducted to develop a model to predict OS at the time of salvage WBRT. Results: The median OS was 6.8 months. OS according to BC-specific graded prognostic assessment (breast-GPA), modified breast-GPA, and updated breast-GPA did not represent our cohort. In the multivariate analysis, a long time before salvage WBRT (>= 16 months), control of primary BC or extracranial metastases, systemic treatment after salvage WBRT, and administration of a biologically effective dose for an alpha/beta of 10 Gy (BED10) of salvage WBRT >37.5 Gy showed superior OS. We proposed three RPA classes based on the control of both primary BC and extracranial metastasis and BED10 of salvage WBRT: class I, class II, and class III. In this model, patients with class I experienced the best OS (34.6 months; class II, 5.0 months; class III, 2.4 months; P < 0.001). Conclusions: In our RPA classification according to the control of both primary BC and extracranial metastasis and the dose of salvage WBRT, significant differences in OS were observed. The subsequent use of a systemic treatment showed better OS. (C) 2021 The Authors. Published by Elsevier Ltd.
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