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Local control of brain metastasis: treatment outcome of focal brain treatments in relation to subtypes

 Jae Uk Chong  ;  Sung Gwe Ahn  ;  Hak Min Lee  ;  Jong Tae Park  ;  Seung Ah Lee  ;  Seho Park  ;  Joon Jeong  ;  Seung Il Kim 
 JOURNAL OF BREAST CANCER, Vol.18(1) : 29-35, 2015 
Journal Title
Issue Date
Brain ; Breast neoplasms ; Cranial irradiation ; Neoplasm metastasis ; Radiosurgery ; Surgery
PURPOSE: To investigate treatment options for local control of metastasis in the brain, we compared focal brain treatment (FBT) with or without whole brain radiotherapy (WBRT) vs. WBRT alone, for breast cancer patients with tumor relapse in the brain. We also evaluated treatment outcomes according to the subtypes. METHODS: We conducted a retrospective review of breast cancer patients with brain metastasis after primary surgery. All patients received at least one local treatment for brain metastasis. Surgery or stereotactic radiosurgery was categorized as FBT. Patients were divided into two groups: the FBT group received FBT±WBRT, whereas the non-FBT group received WBRT alone. Subtypes were defined as follows: hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative, HR-positive/HER2-positive, HR-negative/HER2-positive, and triple-negative (TN). We examined the overall survival after brain metastasis (OSBM), brain metastasis-specific survival (BMSS), and brain metastasis-specific progression-free survival (BMPFS). RESULTS: A total of 116 patients were identified. After a median follow-up of 50.9 months, the median OSBM was 11.5 months (95% confidence interval, 9.0-14.1 months). The FBT group showed significantly superior OSBM and BMSS. However, FBT was not an independent prognostic factor for OSBM and BMSS on multivariate analyses. In contrast, multivariate analyses showed that patients who underwent surgery had improved BMPFS, indicating local control of metastasis in the brain. FBT resulted in better BMPFS in patients with HR-negative/HER2-positive cancer or the TN subtype. CONCLUSION: We found that patients who underwent surgery experienced improved local control of brain metastasis, regardless of its extent. Furthermore, FBT showed positive results and could be considered for better local control of brain metastasis in patients with aggressive subtypes such as HER2-positive and TN.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Seung Il(김승일)
Park, Se Ho(박세호) ORCID logo https://orcid.org/0000-0001-8089-2755
Park, Jong Tae(박종태)
Ahn, Sung Gwe(안성귀) ORCID logo https://orcid.org/0000-0002-8778-9686
Lee, Seung Ah(이승아)
Chong, Jae Uk(정재욱)
Jeong, Joon(정준) ORCID logo https://orcid.org/0000-0003-0397-0005
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