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01-07-2018 | Clinical Study

The breast graded prognostic assessment is associated with the survival outcomes in breast cancer patients receiving whole brain re-irradiation

Authors: Shih-Fan Lai, Yu-Hsuan Chen, Tony Hsiang-Kuang Liang, Che-Yu Hsu, Huang-Chun Lien, Yen-Sen Lu, Chiun-Sheng Huang, Sung-Hsin Kuo

Published in: Journal of Neuro-Oncology | Issue 3/2018

Abstract

Introduction

Whole brain (WB) re-irradiation for breast cancer patients with progressive brain metastasis after first-course WB radiotherapy (WBRT) is controversial. In this study, we sought to investigate the association between the molecular sub-classifications and breast-specific Graded Prognostic Assessment (GPA, which includes the Karnofsky performance status, molecular subtypes, and age as its indices) and the outcomes of breast cancer patients who received WB re-irradiation.

Methods

Twenty-three breast cancer patients who received WB re-irradiation for relapsed and progressive intracranial lesions after first-course WBRT between 2004 and 2016 were retrospectively reviewed. Patients were divided according to the 4 molecular subtypes of luminal A/B (hormone receptor [HR]+/human epidermal growth factor receptor 2 [HER2]−), luminal HER2 (HR+/HER2+), HER2 (HR−/HER2+), and triple negative (HR−/HER2−). The clinical and radiological responses and survival rates after WB re-irradiation were analyzed.

Results

At 1 month after WB re-irradiation, 13 of 23 patients (56.5%) exhibited disappearance or alleviation of neurological symptoms. The median survival time after WB re-irradiation was 2.93 months (95% confidence interval [CI], 1.79–4.08). After WB re-irradiation, patients with HER2-negative tumors had poorer median survival times than those with HER2-positive tumors (2.23 vs. 3.0 months, respectively; p = 0.022). Furthermore, patients with high breast GPA scores (2.5–4.0, n = 11) had longer median survivals than those with low-scores (0–2.0, n = 12) after WB re-irradiation (4.37 vs. 1.57 months, respectively; p < 0.005).

Conclusions

WB re-irradiation may be a feasible treatment option for certain breast cancer patients who develop brain metastatic lesions after first-course WBRT when these lesions are ineligible for radiosurgery or surgery.

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Title: The breast graded prognostic assessment is associated with the survival outcomes in breast cancer patients receiving whole brain re-irradiation
Authors: Shih-Fan Lai
Yu-Hsuan Chen
Tony Hsiang-Kuang Liang
Che-Yu Hsu
Huang-Chun Lien
Yen-Sen Lu
Chiun-Sheng Huang
Sung-Hsin Kuo
Publication date: 01-07-2018
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2018
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2833-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The breast graded prognostic assessment is associated with the survival outcomes in breast cancer patients receiving whole brain re-irradiation

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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