BACKGROUND: New systemic treatments for advanced colorectal cancer have conferred a survival advantage, allowing patients to reach a median survival of almost 2 years. Due to this remarkable life extension, the incidence of brain metastases, though still low, is progressively increasing over time. There is little reported data on the optimal strategy to manage brain lesions from colorectal cancer. METHODS: To explore the role of an aggressive approach to colorectal cancer brain metastases, we retrospectively collected and analyzed data from 30 patients who underwent neurosurgical resection + whole-brain radiotherapy between March 1998 and December 2006. Univariate (logrank) and multivariate (Cox's model) analyses were used to identify prognostic factors. RESULTS: Median age at the time of surgery was 66 years, median ECOG PS was 1, most patients (87%) had concomitant lung and/or liver metastases. Median number of previous chemotherapies was two, with half of the patients being exposed both to oxaliplatin and irinotecan. A median of 27 Gy of radiotherapy were administered to 16 patients after resection. At the time of the analysis, 29 out of 30 patients had died, with a median survival time after brain metastasectomy of 167 days (8-682). Only one patient died within a month from surgery. Median survival was significantly longer in patients who received postsurgical radiotherapy (7.6 vs. 4.7 months, P = 0.014). CONCLUSIONS: Neurosurgical management of symptomatic brain metastases from colorectal cancer is feasible, relatively safe, and offers a chance of prolonged survival. Patients who received radiotherapy after resection experienced a better outcome.
BACKGROUND: New systemic treatments for advanced colorectal cancer have conferred a survival advantage, allowing patients to reach a median survival of almost 2 years. Due to this remarkable life extension, the incidence of brain metastases, though still low, is progressively increasing over time. There is little reported data on the optimal strategy to manage brain lesions from colorectal cancer. METHODS: To explore the role of an aggressive approach to colorectal cancerbrain metastases, we retrospectively collected and analyzed data from 30 patients who underwent neurosurgical resection + whole-brain radiotherapy between March 1998 and December 2006. Univariate (logrank) and multivariate (Cox's model) analyses were used to identify prognostic factors. RESULTS: Median age at the time of surgery was 66 years, median ECOG PS was 1, most patients (87%) had concomitant lung and/or liver metastases. Median number of previous chemotherapies was two, with half of the patients being exposed both to oxaliplatin and irinotecan. A median of 27 Gy of radiotherapy were administered to 16 patients after resection. At the time of the analysis, 29 out of 30 patients had died, with a median survival time after brain metastasectomy of 167 days (8-682). Only one patient died within a month from surgery. Median survival was significantly longer in patients who received postsurgical radiotherapy (7.6 vs. 4.7 months, P = 0.014). CONCLUSIONS: Neurosurgical management of symptomatic brain metastases from colorectal cancer is feasible, relatively safe, and offers a chance of prolonged survival. Patients who received radiotherapy after resection experienced a better outcome.
Authors: R Soffietti; P Cornu; J Y Delattre; R Grant; F Graus; W Grisold; J Heimans; J Hildebrand; P Hoskin; M Kalljo; P Krauseneck; C Marosi; T Siegal; C Vecht Journal: Eur J Neurol Date: 2006-07 Impact factor: 6.089
Authors: Herbert Hurwitz; Louis Fehrenbacher; William Novotny; Thomas Cartwright; John Hainsworth; William Heim; Jordan Berlin; Ari Baron; Susan Griffing; Eric Holmgren; Napoleone Ferrara; Gwen Fyfe; Beth Rogers; Robert Ross; Fairooz Kabbinavar Journal: N Engl J Med Date: 2004-06-03 Impact factor: 91.245
Authors: E M Noordijk; C J Vecht; H Haaxma-Reiche; G W Padberg; J H Voormolen; F H Hoekstra; J T Tans; N Lambooij; J A Metsaars; A R Wattendorff Journal: Int J Radiat Oncol Biol Phys Date: 1994-07-01 Impact factor: 7.038
Authors: P Girard; M Ducreux; P Baldeyrou; P Rougier; T Le Chevalier; J Bougaran; P Lasser; B Gayet; P Ruffié; D Grunenwald Journal: J Clin Oncol Date: 1996-07 Impact factor: 44.544
Authors: Ji Yeon Baek; Myoung Hee Kang; Yong Sang Hong; Tae Won Kim; Dae Yong Kim; Jae Hwan Oh; Seung Hoon Lee; Jin Hong Park; Jong Hoon Kim; Sun Young Kim Journal: J Neurooncol Date: 2011-02-19 Impact factor: 4.130