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Effects of Postoperative Radiotherapy on Leptomeningeal Carcinomatosis or Dural Metastasis after Resection of Brain Metastases in Breast Cancer Patients

Authors
 Boram Ha  ;  Seung Yeun Chung  ;  Yeon-Joo Kim  ;  Ho-Shin Gwak  ;  Jong Hee Chang  ;  Sang Hyun Lee  ;  In Hae Park  ;  Keun Seok Lee  ;  Seeyoun Lee  ;  Tae Hyun Kim  ;  Dae Yong Kim  ;  Seok-Gu Kang  ;  Chang-Ok Suh 
Citation
 CANCER RESEARCH AND TREATMENT, Vol.49(3) : 748-758, 2017 
Journal Title
 CANCER RESEARCH AND TREATMENT 
ISSN
 1598-2998 
Issue Date
2017
MeSH
Adult ; Aged ; Brain Neoplasms/diagnosis ; Brain Neoplasms/secondary* ; Brain Neoplasms/therapy* ; Breast Neoplasms/pathology* ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging/methods ; Meningeal Carcinomatosis/diagnosis ; Meningeal Carcinomatosis/secondary* ; Meningeal Carcinomatosis/therapy* ; Middle Aged ; Postoperative Care ; Radiotherapy ; Receptor, ErbB-2 ; Recurrence ; Retrospective Studies ; Treatment Failure ; Treatment Outcome
Keywords
Breast neoplasms ; Meningeal carcinomatosis ; Partial radiotherapy ; Whole brain radiotherapy
Abstract
PURPOSE: In this retrospective study, we compared the incidence of leptomeningeal carcinomatosis or dural metastasis (LMCDM) in patients who received whole brain radiotherapy (WBRT), partial radiotherapy (PRT), or no radiotherapy (RT) following resection of brain metastases from breast cancer. MATERIALS AND METHODS: Fifty-one patients with breast cancer underwent surgical resection for newly diagnosed brain metastases in two institutions between March 2001 and March 2015. Among these, 34 received postoperative WBRT (n=24) or PRT (n=10) and 17 did not. RESULTS: With a median follow-up of 12.4 months (range, 2.3 to 83.6 months), 22/51 patients developed LMCDM at a median of 8.6 months (range, 4.8 to 51.2 months) after surgery. The 18-months LMCDM-free survival (LMCDM-FS) rates were 77.5%, 30.0%, and 13.6%, in the WBRT, PRT, and no RT groups, respectively (p=0.013). The presence of a tumor adjacent to cerebrospinal fluid flow and no systemic treatment after treatment for brain metastases were also associated with poor LMCDM-FS rate. Multivariate analysis showed that WBRT compared to PRT (p=0.009) and systemic treatment (p < 0.001) were independently associated with reduced incidence of LMCDM. CONCLUSION: WBRT improved LMCDM-FS rate after resection of brain metastases compared to PRT in breast cancer patients.
DOI
10.4143/crt.2016.303
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Suh, Chang Ok(서창옥)
Chang, Jong Hee(장종희)
Chung, Seung Yeun(정승연) ORCID logo https://orcid.org/0000-0002-3877-6950
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160475
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