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Comparison of initial and sequential salvage brain-directed treatment in patients with 1-4 vs. 5-10 brain metastases from breast cancer (KROG 16-12)

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Author(s)
Jae Sik KimKyubo KimWonguen JungKyung Hwan ShinSeock-Ah ImHee-Jun KimYong Bae KimJee Suk ChangJee Hyun KimDoo Ho ChoiYeon Hee ParkDae Yong KimTae Hyun KimByung Ock ChoiSea-Won LeeSuzy KimJeanny KwonKi Mun KangWoong-Ki ChungKyung Su KimWon Sup YoonJin Hee KimJihye ChaYoon Kyeong OhIn Ah Kim
Keimyung Author(s)
Kim, Jin Hee
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Breast Cancer Res Treat
Issued Date
2023
Volume
200
Issue
1
Keyword
Brain metastasisBreast cancerOverall survivalSalvage treatmentWhole-brain radiotherapy
Abstract
Purpose:
We aimed to compare the initial and salvage brain-directed treatment and overall survival (OS) between patients with 1-4 brain metastases (BMs) and those with 5-10 from breast cancer (BC). We also organized a decision tree to select the initial whole-brain radiotherapy (WBRT) for these patients.

Methods:
Between 2008 and 2014, 471 patients were diagnosed with 1-10 BMs. They were divided into two groups based on the number of BM: 1-4 BMs (n = 337) and 5-10 BMs (n = 134). Median follow-up duration was 14.0 months.

Results:
Stereotactic radiosurgery (SRS)/fractionated stereotactic radiotherapy (FSRT) was the most common treatment modality (n = 120, 36%) in the 1-4 BMs group. In contrast, 80% (n = 107) of patients with 5-10 BMs were treated with WBRT. The median OS of the entire cohort, 1-4 BMs, and 5-10 BMs was 18.0, 20.9, and 13.9 months, respectively. In the multivariate analysis, the number of BM and WBRT were not associated with OS, whereas triple-negative BC and extracranial metastasis decreased OS. Physicians determined the initial WBRT based on four variables in the following order: number and location of BM, primary tumor control, and performance status. Salvage brain-directed treatment (n = 184), mainly SRS/FSRT (n = 109, 59%), prolonged OS by a median of 14.3 months.

Conclusion:
The initial brain-directed treatment differed notably according to the number of BM, which was chosen based on four clinical factors. In patients with ≤ 10 BMs, the number of BM and WBRT did not affect OS. The major salvage brain-directed treatment modality was SRS/FSRT and increased OS.
Keimyung Author(s)(Kor)
김진희
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1573-7217
Source
https://link.springer.com/article/10.1007/s10549-023-06936-w
DOI
10.1007/s10549-023-06936-w
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44956
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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