Carsten Nieder1,2, Mandy Hintz3, Ilinca Popp3,4, Angelika Bilger3,4, Anca L Grosu3,4. 1. Department of Oncology and Palliative Medicine, Nordland Hospital, 8092 Bodø, Norway. 2. Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, 9037 Tromsø, Norway. 3. Department of Radiation Oncology, University Hospital Freiburg, 79106 Freiburg, Germany. 4. German Cancer Consortium (DKTK), Partner Site Freiburg, Germany.
Abstract
AIM: The aim of this study was to characterize the survival results of patients with up to four brain metastases after intense local therapy (primary surgery or stereotactic radiotherapy) if extracranial metastases were absent or limited to one site, e.g. the lungs. BACKGROUND: Oligometastatic disease has repeatedly been reported to convey a favorable prognosis. MATERIAL AND METHODS: This retrospective study included 198 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy. Information about age, extracranial spread, number of brain metastases, performance status and other variables was collected. Uni- and multivariate tests were performed. RESULTS: Median survival was 16.5 months (single brain metastasis) and 9.8 months (2-4, comparable survival for 2, 3 and 4), respectively (p = 0.001). After 5 years, 15 and 2% of the patients were still alive. In patients alive after 2 years, added median survival was 23 months and the probability of being alive 5 years after treatment was 26%. In multivariate analysis, extracranial metastases were not significantly associated with survival, while primary tumor control was. CONCLUSION: Long-term survival beyond 5 years is possible in a minority of patients with oligometastatic brain disease, in particular those with a single brain metastasis. The presence of extracranial metastases to one site should not be regarded a barrier towards maximum brain-directed therapy.
AIM: The aim of this study was to characterize the survival results of patients with up to four brain metastases after intense local therapy (primary surgery or stereotactic radiotherapy) if extracranial metastases were absent or limited to one site, e.g. the lungs. BACKGROUND: Oligometastatic disease has repeatedly been reported to convey a favorable prognosis. MATERIAL AND METHODS: This retrospective study included 198 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy. Information about age, extracranial spread, number of brain metastases, performance status and other variables was collected. Uni- and multivariate tests were performed. RESULTS: Median survival was 16.5 months (single brain metastasis) and 9.8 months (2-4, comparable survival for 2, 3 and 4), respectively (p = 0.001). After 5 years, 15 and 2% of the patients were still alive. In patients alive after 2 years, added median survival was 23 months and the probability of being alive 5 years after treatment was 26%. In multivariate analysis, extracranial metastases were not significantly associated with survival, while primary tumor control was. CONCLUSION: Long-term survival beyond 5 years is possible in a minority of patients with oligometastatic brain disease, in particular those with a single brain metastasis. The presence of extracranial metastases to one site should not be regarded a barrier towards maximum brain-directed therapy.
Authors: Thiru Prasanna; Christos S Karapetis; David Roder; Jeanne Tie; Robert Padbury; Timothy Price; Rachel Wong; Jeremy Shapiro; Louise Nott; Margaret Lee; Yu Jo Chua; Paul Craft; Cynthia Piantadosi; Michael Sorich; Peter Gibbs; Desmond Yip Journal: Acta Oncol Date: 2018-07-23 Impact factor: 4.089
Authors: Rupesh Kotecha; Sally Vogel; John H Suh; Gene H Barnett; Erin S Murphy; Chandana A Reddy; Michael Parsons; Michael A Vogelbaum; Lilyana Angelov; Alireza M Mohammadi; Glen H J Stevens; David M Peereboom; Manmeet S Ahluwalia; Samuel T Chao Journal: J Neurooncol Date: 2016-07-25 Impact factor: 4.130
Authors: Phillip J Gray; Raymond H Mak; Beow Y Yeap; Sarah K Cryer; Nancy E Pinnell; Laura W Christianson; David J Sher; Nils D Arvold; Elizabeth H Baldini; Aileen B Chen; David E Kozono; Scott J Swanson; David M Jackman; Brian M Alexander Journal: Lung Cancer Date: 2014-06-06 Impact factor: 5.705
Authors: Pim B van der Meer; Esther J J Habets; Ruud G Wiggenraad; Antoinette Verbeek-de Kanter; Geert J Lycklama À Nijeholt; Hanneke Zwinkels; Martin Klein; Linda Dirven; Martin J B Taphoorn Journal: J Neurooncol Date: 2018-04-16 Impact factor: 4.130
Authors: Annkathrin Hanssen; Carlotta Riebensahm; Malte Mohme; Simon A Joosse; Janna-Lisa Velthaus; Lars Arne Berger; Christian Bernreuther; Markus Glatzel; Sonja Loges; Katrin Lamszus; Manfred Westphal; Sabine Riethdorf; Klaus Pantel; Harriet Wikman Journal: Cancers (Basel) Date: 2018-12-19 Impact factor: 6.639
Authors: Margarita Martin; Raúl Hernanz; Carmen Vallejo; Leonardo Guerrero; Xabier Mielgo; Ana Lopez; Juan Carlos Trujillo-Reyes; Felipe Couñago Journal: Rep Pract Oncol Radiother Date: 2022-07-29