https://scholars.lib.ntu.edu.tw/handle/123456789/470165
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 HSIANG-KUANG LIANG CHE-YU HSU HUANG-CHUN LIEN Lu Y.-S. CHIUN-SHENG HUANG SUNG-HSIN KUO |
Issue Date: | 2018 | Publisher: | Springer New York LLC | Journal Volume: | 138 | Journal Issue: | 3 | Start page/Pages: | 637-647 | Source: | Journal of Neuro-Oncology | 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. ? 2018, Springer Science+Business Media, LLC, part of Springer Nature. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046008835&doi=10.1007%2fs11060-018-2833-5&partnerID=40&md5=513b3af940193796ba2af8ee504341d0 https://scholars.lib.ntu.edu.tw/handle/123456789/470165 |
ISSN: | 0167-594X | DOI: | 10.1007/s11060-018-2833-5 | SDG/Keyword: | adult; Article; brain damage; brain metastasis; brain radiography; breast cancer; cancer staging; cancer survival; clinical article; clinical feature; controlled study; female; follow up; Graded Prognostic Assessment; hearing impairment; human; human epidermal growth factor receptor 2 positive breast cancer; luminal A breast cancer; luminal B breast cancer; medical record review; prognostic assessment; re-irradiation; relapse; retrospective study; secretory otitis media; survival rate; survival time; treatment response; triple negative breast cancer; whole brain radiotherapy; brain tumor; breast tumor; disease exacerbation; metabolism; middle aged; mortality; pathology; prognosis; skull irradiation; survival analysis; epidermal growth factor receptor 2; ERBB2 protein, human; HR protein, human; transcription factor; tumor marker; Adult; Biomarkers, Tumor; Brain Neoplasms; Breast Neoplasms; Cranial Irradiation; Disease Progression; Humans; Middle Aged; Prognosis; Re-Irradiation; Receptor, ErbB-2; Retrospective Studies; Survival Analysis; Transcription Factors |
Appears in Collections: | 病理學科所 |
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