Ogawa Kazuhiko, Yoshii Yoshihiko, Nishimaki Tadashi, Tamaki Nobumitsu, Miyaguni Takao, Tsuchida Yukihiro, Kamada Yoshihiko, Toita Takafumi, Kakinohana Yasumasa, Tamaki Wakana, Iraha Shiro, Adachi Genki, Hyodo Akio, Murayama Sadayuki
Department of Radiology, University of the Ryukyus School of Medicine, 207 Uehara, Nishihara-cho, Okinawa, Japan.
J Neurooncol. 2008 Jan;86(2):231-8. doi: 10.1007/s11060-007-9469-1. Epub 2007 Sep 12.
To analyze retrospectively the results of treatments for patients with brain metastases from breast cancer.
The records of 65 breast cancer patients with brain metastases who were treated between 1985 and 2005 were reviewed. For brain metastases, 11 patients (17%) were treated with surgical resection followed by radiotherapy, and the remaining 54 patients were treated with radiotherapy alone. Systemic chemotherapy was also administered to 11 patients after brain radiotherapy.
The overall median survival for all patients was 6.1 months (range, 0.4-82.2 months). In univariate analysis, treatment modality, Karnofsky performance status (KPS), administration of systemic chemotherapy, extracranial disease status and total radiation dose each had significant impact on overall survival, and in multivariate analysis, treatment modality, KPS and administration of systemic chemotherapy were significant prognostic factors. Eight patients survived for more than 2 years after the diagnosis of brain metastases, and all these patients were treated with surgical resection and/or systemic chemotherapy in addition to radiotherapy. For the 45 patients treated with palliative radiotherapy (without systemic chemotherapy), the improvements in neurological symptoms were observed in 35 patients (78%), with the median duration of improvement of 3.1 months (range, 1.5-4.4 months).
The prognoses for patients with brain metastases from breast cancer were generally poor, although selected patients may survive longer with intensive brain tumor treatment, such as surgical resection and/or systemic chemotherapy in addition to brain radiotherapy. For patients with unfavorable prognoses, palliative radiotherapy was effective in improving the quality of the remaining lifetime.
回顾性分析乳腺癌脑转移患者的治疗结果。
回顾了1985年至2005年间接受治疗的65例乳腺癌脑转移患者的记录。对于脑转移,11例患者(17%)接受了手术切除并随后进行放疗,其余54例患者仅接受放疗。11例患者在脑部放疗后还接受了全身化疗。
所有患者的总中位生存期为6.1个月(范围0.4 - 82.2个月)。单因素分析中,治疗方式、卡氏功能状态评分(KPS)、全身化疗的应用、颅外疾病状态和总放射剂量对总生存期均有显著影响,多因素分析中,治疗方式、KPS和全身化疗的应用是显著的预后因素。8例患者在诊断脑转移后存活超过2年,所有这些患者除放疗外还接受了手术切除和/或全身化疗。对于45例接受姑息性放疗(未进行全身化疗)的患者,35例(78%)患者的神经症状有改善,改善的中位持续时间为3.1个月(范围1.5 - 4.4个月)。
乳腺癌脑转移患者的预后总体较差,尽管部分患者通过强化的脑肿瘤治疗,如除脑部放疗外还进行手术切除和/或全身化疗,可能存活更长时间。对于预后不良的患者,姑息性放疗可有效改善剩余生存期的质量。