BACKGROUND: The objective of this study was to review the outcome of women with breast cancer with known receptor status who were treated with whole brain radiotherapy for brain metastases and to determine factors that impact survival. METHODS: A total of 223 women with breast cancer and brain metastases, who received whole brain radiotherapy, were identified. All women with HER-2-positive disease had received trastuzumab. Kaplan-Meier product limit method was used to determine overall survival (OS) estimates. Cox proportional hazards models were then fitted to explore the association of OS with various patient and tumor characteristics. RESULTS: Median age at brain metastases diagnosis was 50 years. Sixty-seven (30.2%) patients had hormone receptor-positive/HER-2-negative disease, 101 (45.50%) had HER-2-positive disease, and 54 (24.3%) had triple receptor-negative disease. Median OS from brain metastases was 6 months, with 1-year survival of 30% (95% confidence interval [CI], 23%-36%). Women with hormone receptor-positive/HER-2-negative, HER-2-positive, and triple-negative tumors had median survivals of 5, 9, and 5 months, respectively (P = .0069). In the multivariate model, women with HER-2-positive disease had a significantly decreased risk of death compared with women with hormone receptor-positive/HER-2-negative disease (hazard ratio, 0.63; 95%CI, 0.42-0.94; P = .02). The risk of death among women with triple-negative disease compared with hormone receptor-positive/HER-2-negative disease was not significantly different (P = .54). Lower recursive partitioning analysis class and > or = 30-gray brain radiation dose were also significantly associated with a decreased risk of death. CONCLUSIONS: Breast tumor subtype has a significant prognostic role among women with breast cancer and brain metastases. In addition, in the trastuzumab era factors such as recursive partitioning analysis and adequate radiation dose continue to be important prognostic factors.
BACKGROUND: The objective of this study was to review the outcome of women with breast cancer with known receptor status who were treated with whole brain radiotherapy for brain metastases and to determine factors that impact survival. METHODS: A total of 223 women with breast cancer and brain metastases, who received whole brain radiotherapy, were identified. All women with HER-2-positive disease had received trastuzumab. Kaplan-Meier product limit method was used to determine overall survival (OS) estimates. Cox proportional hazards models were then fitted to explore the association of OS with various patient and tumor characteristics. RESULTS: Median age at brain metastases diagnosis was 50 years. Sixty-seven (30.2%) patients had hormone receptor-positive/HER-2-negative disease, 101 (45.50%) had HER-2-positive disease, and 54 (24.3%) had triple receptor-negative disease. Median OS from brain metastases was 6 months, with 1-year survival of 30% (95% confidence interval [CI], 23%-36%). Women with hormone receptor-positive/HER-2-negative, HER-2-positive, and triple-negative tumors had median survivals of 5, 9, and 5 months, respectively (P = .0069). In the multivariate model, women with HER-2-positive disease had a significantly decreased risk of death compared with women with hormone receptor-positive/HER-2-negative disease (hazard ratio, 0.63; 95%CI, 0.42-0.94; P = .02). The risk of death among women with triple-negative disease compared with hormone receptor-positive/HER-2-negative disease was not significantly different (P = .54). Lower recursive partitioning analysis class and > or = 30-gray brain radiation dose were also significantly associated with a decreased risk of death. CONCLUSIONS:Breast tumor subtype has a significant prognostic role among women with breast cancer and brain metastases. In addition, in the trastuzumab era factors such as recursive partitioning analysis and adequate radiation dose continue to be important prognostic factors.
Authors: Ashraf S Mahmoud-Ahmed; John H Suh; Shih-Yuan Lee; Richard L Crownover; Gene H Barnett Journal: Int J Radiat Oncol Biol Phys Date: 2002-11-01 Impact factor: 7.038
Authors: C M Perou; T Sørlie; M B Eisen; M van de Rijn; S S Jeffrey; C A Rees; J R Pollack; D T Ross; H Johnsen; L A Akslen; O Fluge; A Pergamenschikov; C Williams; S X Zhu; P E Lønning; A L Børresen-Dale; P O Brown; D Botstein Journal: Nature Date: 2000-08-17 Impact factor: 49.962
Authors: L Gaspar; C Scott; M Rotman; S Asbell; T Phillips; T Wasserman; W G McKenna; R Byhardt Journal: Int J Radiat Oncol Biol Phys Date: 1997-03-01 Impact factor: 7.038
Authors: S Dawood; K Broglio; F J Esteva; N K Ibrahim; S-W Kau; R Islam; K D Aldape; T-K Yu; G N Hortobagyi; A M Gonzalez-Angulo Journal: Ann Oncol Date: 2008-03-11 Impact factor: 32.976
Authors: Paul W Sperduto; Norbert Kased; David Roberge; Zhiyuan Xu; Ryan Shanley; Xianghua Luo; Penny K Sneed; Samuel T Chao; Robert J Weil; John Suh; Amit Bhatt; Ashley W Jensen; Paul D Brown; Helen A Shih; John Kirkpatrick; Laurie E Gaspar; John B Fiveash; Veronica Chiang; Jonathan P S Knisely; Christina Maria Sperduto; Nancy Lin; Minesh Mehta Journal: Int J Radiat Oncol Biol Phys Date: 2011-04-15 Impact factor: 7.038
Authors: Apostolia Maria Tsimberidou; Katherine Letourneau; Sijin Wen; Jennifer Wheler; David Hong; Aung Naing; Nancy G Iskander; Cynthia Uehara; Razelle Kurzrock Journal: Clin Cancer Res Date: 2011-03-17 Impact factor: 12.531
Authors: Andrew T Roehrig; Ethan A Ferrel; Devon A Benincosa; Alexander R MacKay; Benjamin C Ling; Jonathan D Carlson; John J Demakas; Aaron Wagner; Wayne T Lamoreaux; Robert K Fairbanks; Jason A Call; Barton S Cooke; Ben Peressini; Christopher M Lee Journal: Surg Neurol Int Date: 2016-11-14
Authors: Leticia De Mattos-Arruda; Charlotte K Y Ng; Salvatore Piscuoglio; Maria Gonzalez-Cao; Raymond S Lim; Maria R De Filippo; Nicola Fusco; Anne M Schultheis; Carolina Ortiz; Santiago Viteri; Alexandra Arias; Gabriel S Macedo; Mafalda Oliveira; Patricia Gomez; Cristina Teixidó; Paolo Nuciforo; Vicente Peg; Cristina Saura; Santiago Ramon Y Cajal; Francesc Tresserra Casas; Britta Weigelt; Javier Cortes; Joan Seoane; Jorge S Reis-Filho Journal: Oncotarget Date: 2018-04-17