Survival Outcomes of Breast Cancer Patients With Brain Metastases: A Multicenter Retrospective Study in Korea (KROG 16-12)
- Jae Sik Kim; Kyubo Kim; Wonguen Jung; Kyung Hwan Shin; Seock-Ah Im; Hee-Jun Kim; Yong Bae Kim; Jee Suk Chang; Doo Ho Choi; Yeon Hee Park; Dae Yong Kim; Tae Hyun Kim; Byung Ock Choi; Sea-Won Lee; Suzy Kim; Jeanny Kwon; Ki Mun Kang; Woong-Ki Chung; Kyung Su Kim; Ji Ho Namo; Won Sup Yoon; Jin Hee Kim; Jihye Cha; Yoon Kyeong Oh; In Ah Kim
- Dept. of Radiation Oncology (방사선종양학)
- Issue Date
- Breast, Vol.49() : 41-47, 2019
This study evaluated the influence of prognostic factors and whole brain radiotherapy (WBRT) on overall survival (OS) of breast cancer (BC) patients with brain metastases (BM).
Methods and materials:
Medical records of 730 BC patients diagnosed with BM from 2000 to 2014 at 17 institutions were retrospectively reviewed. OS was calculated from BM diagnosis. Median follow-up duration was 11.9 months (range, 0.1-126.2).
Median OS was 15.0 months (95% CI: 14.0-16.9). Patients with different BC-specific graded prognostic assessment (GPA) scores showed significant differences (p < 0.001) in OS. In multivariate analysis, histologic grade 3 (p = 0.014), presence of extracranial metastasis (p < 0.001), the number of BM (>4; p = 0.002), hormone receptor negativity (p = 0.005), HER2-negativity (p = 0.003), and shorter time interval (<30 months) between BC and BM diagnosis (p = 0.007) were associated with inferior OS. By summing the β-coefficients of variables that were prognostic in multivariate analyses, we developed a prognostic model that stratified patients into low-risk (≤0.673) and high-risk (>0.673) subgroups; the high-risk subgroup had poorer median OS (10.1 months, 95% CI: 7.9-11.9 vs. 21.9 months, 95% CI: 19.5-27.1, p < 0.001). Univariate and multivariate analyses of propensity score-matched patients diagnosed with BM ≥ 30 months after BC diagnosis (n = 389, "late BM") revealed that WBRT-treated patients showed superior OS compared to non-WBRT-treated patients (p = 0.070 and 0.030, respectively).
Our prognostic model identified high-risk BC patients with BM who might benefit from increased surveillance; if validated, our model could guide treatment selection for such patients. Patients with late BM might benefit from WBRT as initial local treatment.
- Brain metastasis; Breast cancer; Overall survival; Prognostic model; Whole brain radiotherapy
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- 1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
- Keimyung Author(s)
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