GAMMA KNIFE RADIOSURGERY FOR BRAIN METASTASES FROM PRIMARY BREAST CANCER
GAMMA KNIFE RADIOSURGERY FOR BRAIN METASTASES FROM PRIMARY BREAST CANCER
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DOI：
10.1016/j.ijrobp.2008.12.031
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发表时间：
2009-11-15
影响因子：
7
通讯作者：
Sneed, Penny K.
中科院分区：
文献类型：
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作者：
Kased, Norbert;Binder, Devin K.;Sneed, Penny K.
目的：立体定向放射手术（SRS）与全脑放疗（WBRT）在乳腺癌脑转移患者治疗中的相对作用尚不明确。在这项研究中，我们回顾了我们治疗这些患者的经验。材料和方法：我们回顾性分析了1991年至2005年间所有接受伽玛刀SRS治疗的乳腺癌脑转移患者。采用Kaplan-Meier方法计算精算生存期和进展终点的自由度。结果：1991年至2005年间，176例乳腺癌脑转移患者接受了SRS治疗。95例新诊断患者的中位生存时间为16.0个月，81例复发性脑转移患者的中位生存时间为11.7个月。在新诊断的患者中，遗漏前期WBRT对MST （P = 0.20）、脑进展自由（P = 0.75）或新脑转移自由（P = 0.83）没有显著影响。较长的生存期与年龄= 70、原发肿瘤控制、雌激素受体阳性和Her2/neu过表达有关。治疗的脑转移瘤数量与生存时间之间没有关联。结论：我们描述了SRS治疗新诊断或复发性脑转移的乳腺癌患者的预后因素。大多数患者亚群的中位生存时间为11个月。出乎意料的是，前期WBRT似乎并没有改善大脑免于进展，并且大量的脑转移与较短的生存时间无关。在预后因素和WBRT和SRS在脑转移中的作用方面，乳腺癌可能与其他原发部位不同。(C) 2009爱思唯尔公司
Purpose: The relative roles of stereotactic radiosurgery (SRS) vs. whole brain radiotherapy (WBRT) in the treatment of patients with brain metastases from breast cancer remain undefined. In this study, we reviewed our experience with these patients.Materials and Methods: We retrospectively reviewed all patients treated between 1991 and 2005 with Gamma Knife SRS for brain metastases from breast cancer. The actuarial survival and freedom from progression end-points were calculated using the Kaplan-Meier method.Results: Between 1991 and 2005,176 patients underwent SRS for brain metastases from breast cancer. The median survival time was 16.0 months for 95 newly diagnosed patients and 11.7 months for 81 patients with recurrent brain metastases. In the newly diagnosed patients, omission of upfront WBRT did not significantly affect the MST (P = .20), brain freedom from progression (p = .75), or freedom from new brain metastases (p = .83). Longer survival was associated with age = 70, primary tumor control, estrogen receptor positivity, and Her2/neu overexpression. No association was found between the number of treated brain metastases and the survival time.Conclusion: We have described prognostic factors for breast cancer patients treated with SRS for newly diagnosed or recurrent brain metastases. Most patient subsets had a median survival time of 11 months. Unexpectedly, upfront WBRT did not appear to improve brain freedom from progression, and a larger number of brain metastases was not associated with a shorter survival time. Breast cancer might be distinct from other primary sites in terms of prognostic factors and the roles of WBRT and SRS for brain metastases. (C) 2009 Elsevier Inc.