Liu Mu-Tai, Hsieh Chang-Yao, Wang Ai-Yih, Chang Tung-Hao, Pi Chu-Pin, Huang Chia-Chun, Huang Chao-Yuan, Liou Cheng-Hong
Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan, Republic of China.
Support Care Cancer. 2006 Sep;14(9):936-42. doi: 10.1007/s00520-006-0029-6. Epub 2006 Mar 31.
The purpose of this study is to analyze the overall survival rate of patients with brain metastases from breast cancer and to determine prognostic factors affecting outcomes of these patients.
From July 1988 to December 2004, 48 female patients with brain metastases from breast cancer underwent full-dose whole-brain radiotherapy (WBRT). In these patients we evaluated the significance of the following factors in predicting the survival rate after WBRT: age, extracranial metastases, number of brain metastases, total dose of WBRT, Karnofsky performance status (KPS), and Radiation Therapy Oncology Group recursive partitioning analysis (RPA) class.
The median overall survival rate was 7.3 months. The 1- and 2-year overall survival rates were 37 and 20%, respectively. In univariate analysis, KPS (p<0.0001), number of lesions of brain metastases (p=0.0149), age (p=0.0452), and RPA class (p<0.0001) were statistically significant prognostic factors for overall survival. In multivariate analysis, KPS (p<0.001) and number of brain metastases (p=0.039) were significant prognostic factors for overall survival.
Survival of breast cancer patients with brain metastases treated with WBRT is poor. To improve survival, enrollment of more patients with brain metastases from breast cancer for prospective trials involving a multimodality approach that combines radiation and systemic therapies based on appropriate patient triage is warranted.
本研究的目的是分析乳腺癌脑转移患者的总生存率,并确定影响这些患者预后的因素。
1988年7月至2004年12月,48例乳腺癌脑转移女性患者接受了全剂量全脑放疗(WBRT)。在这些患者中,我们评估了以下因素对预测WBRT后生存率的意义:年龄、颅外转移、脑转移灶数量、WBRT总剂量、卡诺夫斯基功能状态(KPS)以及放射治疗肿瘤学组递归分区分析(RPA)分级。
总生存期中位数为7.3个月。1年和2年总生存率分别为37%和20%。单因素分析中,KPS(p<0.0001)、脑转移灶数量(p=0.0149)、年龄(p=0.0452)和RPA分级(p<0.0001)是总生存的统计学显著预后因素。多因素分析中,KPS(p<0.001)和脑转移灶数量(p=0.039)是总生存的显著预后因素。
接受WBRT治疗的乳腺癌脑转移患者生存率较低。为提高生存率,有必要纳入更多乳腺癌脑转移患者进行前瞻性试验,采用基于适当患者分类的放疗与全身治疗相结合的多模式方法。