Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions
Abstract Background Breast cancer brain metastases (BCBM) are highly heterogenous with widely differing survival. The prognosis of the oligometastatic breast cancer (BC) patients with brain metastases (BM) has not been well studied. We aimed to investigate the prognosis of BCBM patients with limited...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13014-023-02293-6 |
| _version_ | 1797789638824296448 |
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| author | Wei Shi Yang Li Hua Sun Li Zhang Jin Meng Xiaofang Wang Xingxing Chen Xiaomeng Zhang Xin Mei Jinli Ma Miao Mo Changming Zhou Fei Liang Zhimin Shao Zhen Zhang Xiaomao Guo Xiaoli Yu Zhaozhi Yang |
| author_facet | Wei Shi Yang Li Hua Sun Li Zhang Jin Meng Xiaofang Wang Xingxing Chen Xiaomeng Zhang Xin Mei Jinli Ma Miao Mo Changming Zhou Fei Liang Zhimin Shao Zhen Zhang Xiaomao Guo Xiaoli Yu Zhaozhi Yang |
| author_sort | Wei Shi |
| collection | DOAJ |
| description | Abstract Background Breast cancer brain metastases (BCBM) are highly heterogenous with widely differing survival. The prognosis of the oligometastatic breast cancer (BC) patients with brain metastases (BM) has not been well studied. We aimed to investigate the prognosis of BCBM patients with limited intracranial and extracranial metastatic lesions. Methods Four hundred and forty-five BCBM patients treated between 1st January 2008 and 31st December 2018 at our institute were included. Clinical characteristics and treatment information were obtained from patient’s medical records. The updated breast Graded Prognostic Assessment (Breast GPA) was calculated. Results The median OS after diagnosis of BM were 15.9 months. Median OS for patients with GPA 0–1.0, 1.5–2, 2.5–3 and 3.5–4 were 6.9, 14.2, 21.8, 42.6 months respectively. The total number of intracranial and extracranial metastatic lesions, in addition to the Breast GPA, salvage local therapy and systemic therapy (anti-HER2 therapy, chemotherapy and endocrine therapy) were demonstrated to be associated with prognosis. One hundred and thirteen patients (25.4%) had 1–5 total metastatic lesions at BM diagnosis. Patients with 1–5 total metastatic lesions had a significantly longer median OS of 24.3 months compared to those with greater than 5 total metastatic lesions with a median OS of 12.2 months (P < 0.001; multivariate HR 0.55, 95% CI, 0.43–0.72). Among the patients with 1–5 metastatic lesions, median OS for GPA 0–1.0 was 9.8 months, compared to 22.8, 28.8 and 71.0 for GPA 1.5–2.0, 2.5–3.0 and 3.5–4.0 respectively, which is much longer than the corresponding patients with greater than 5 total metastatic lesions, with medium OS of 6.8, 11.6, 18.6 and 42.6 months respectively for GPA 0–1.0, 1.5–2.0, 2.5–3.0 and 3.5–4.0. Conclusions The patients with 1–5 total metastatic lesions demonstrated better OS. The prognostic value of the Breast GPA and the survival benefit of salvage local therapy and continuation of systemic therapy after BM were confirmed. |
| first_indexed | 2024-03-13T01:53:32Z |
| format | Article |
| id | doaj.art-772cef6c58cd4fddb0257b2f8242609e |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-03-13T01:53:32Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-772cef6c58cd4fddb0257b2f8242609e2023-07-02T11:22:10ZengBMCRadiation Oncology1748-717X2023-07-0118111210.1186/s13014-023-02293-6Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesionsWei Shi0Yang Li1Hua Sun2Li Zhang3Jin Meng4Xiaofang Wang5Xingxing Chen6Xiaomeng Zhang7Xin Mei8Jinli Ma9Miao Mo10Changming Zhou11Fei Liang12Zhimin Shao13Zhen Zhang14Xiaomao Guo15Xiaoli Yu16Zhaozhi Yang17Department of Radiation Oncology, Fudan University Shanghai Cancer CenterAffiliated Hospital of Jining Medical UniversityDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Cancer Prevention and Clinical Statistics Center, Fudan University Shanghai Cancer CenterDepartment of Cancer Prevention and Clinical Statistics Center, Fudan University Shanghai Cancer CenterDepartment of Biostatistics, Zhongshan Hospital, Fudan UniversityDepartment of Breast Surgery, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterDepartment of Radiation Oncology, Fudan University Shanghai Cancer CenterAbstract Background Breast cancer brain metastases (BCBM) are highly heterogenous with widely differing survival. The prognosis of the oligometastatic breast cancer (BC) patients with brain metastases (BM) has not been well studied. We aimed to investigate the prognosis of BCBM patients with limited intracranial and extracranial metastatic lesions. Methods Four hundred and forty-five BCBM patients treated between 1st January 2008 and 31st December 2018 at our institute were included. Clinical characteristics and treatment information were obtained from patient’s medical records. The updated breast Graded Prognostic Assessment (Breast GPA) was calculated. Results The median OS after diagnosis of BM were 15.9 months. Median OS for patients with GPA 0–1.0, 1.5–2, 2.5–3 and 3.5–4 were 6.9, 14.2, 21.8, 42.6 months respectively. The total number of intracranial and extracranial metastatic lesions, in addition to the Breast GPA, salvage local therapy and systemic therapy (anti-HER2 therapy, chemotherapy and endocrine therapy) were demonstrated to be associated with prognosis. One hundred and thirteen patients (25.4%) had 1–5 total metastatic lesions at BM diagnosis. Patients with 1–5 total metastatic lesions had a significantly longer median OS of 24.3 months compared to those with greater than 5 total metastatic lesions with a median OS of 12.2 months (P < 0.001; multivariate HR 0.55, 95% CI, 0.43–0.72). Among the patients with 1–5 metastatic lesions, median OS for GPA 0–1.0 was 9.8 months, compared to 22.8, 28.8 and 71.0 for GPA 1.5–2.0, 2.5–3.0 and 3.5–4.0 respectively, which is much longer than the corresponding patients with greater than 5 total metastatic lesions, with medium OS of 6.8, 11.6, 18.6 and 42.6 months respectively for GPA 0–1.0, 1.5–2.0, 2.5–3.0 and 3.5–4.0. Conclusions The patients with 1–5 total metastatic lesions demonstrated better OS. The prognostic value of the Breast GPA and the survival benefit of salvage local therapy and continuation of systemic therapy after BM were confirmed.https://doi.org/10.1186/s13014-023-02293-6Brain metastasesBreast cancerOligometastasesSystemic therapySalvage local therapy |
| spellingShingle | Wei Shi Yang Li Hua Sun Li Zhang Jin Meng Xiaofang Wang Xingxing Chen Xiaomeng Zhang Xin Mei Jinli Ma Miao Mo Changming Zhou Fei Liang Zhimin Shao Zhen Zhang Xiaomao Guo Xiaoli Yu Zhaozhi Yang Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions Radiation Oncology Brain metastases Breast cancer Oligometastases Systemic therapy Salvage local therapy |
| title | Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions |
| title_full | Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions |
| title_fullStr | Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions |
| title_full_unstemmed | Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions |
| title_short | Favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions |
| title_sort | favorable prognosis of breast cancer brain metastases patients with limited intracranial and extracranial metastatic lesions |
| topic | Brain metastases Breast cancer Oligometastases Systemic therapy Salvage local therapy |
| url | https://doi.org/10.1186/s13014-023-02293-6 |
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