Chew Sonya, Carroll Hailey Kathryn, Darwish Waseem, Boychak Oleksandr, Higgins Michaela, McCaffrey John, Kelly Catherine Margaret
Department of Medical Oncology, Mater Misericordiae University Hospital, Dublin, Ireland.
Department of Radiation Oncology, St Luke's Radiation Oncology Network, Beaumont Hospital, Dublin, Ireland.
Cancer Manag Res. 2021 Nov 2;13:8191-8198. doi: 10.2147/CMAR.S330829. eCollection 2021.
Around 30% of patients with breast cancer will develop brain metastases (BM). We sought to characterize the disease course, treatments and outcome for our patient cohort.
We extracted clinicopathological data from electronic records from January 2015 to December 2020. Results were generated using SPSS statistics v27.
We identified 98 patients. Median overall survival (OS) from BM diagnosis was 3 months [hormone receptor (HR)+/human epidermal growth factor receptor 2 (HER2)-], 8 months [HR+/HER2+], 7 months [HR-/HER2+] and 2 months [triple negative breast cancer (TNBC)]. Whole brain radiotherapy (WBRT) (n=48, 70%) was most frequently used followed by surgery (n=15, 22%) and stereotactic radiosurgery (n=6, 8%). In patients who received WBRT alone (n=40) the median OS post WBRT was 2.6 months.
After BM development, half of the patients had systemic therapy and 70% had local therapy, but only the HER2 subgroup had a prolonged OS likely reflecting central nervous system (CNS) activity of anti-HER2 drugs. TNBC patients had the worst prognosis. Although our cohort is small, OS was >1 year for 60% of HER2+ patients who received trastuzumab emtansine after BM development, which is encouraging for antibody drug conjugates and CNS activity. Patients who received WBRT had a higher burden of CNS disease and had an OS of less than 3 months.
约30%的乳腺癌患者会发生脑转移（BM）。我们试图描述我们患者队列的疾病进程、治疗方法和预后。
我们从2015年1月至2020年12月的电子记录中提取临床病理数据。结果使用SPSS统计软件v27生成。
我们确定了98例患者。从BM诊断开始的中位总生存期（OS）为3个月[激素受体（HR）+/人表皮生长因子受体2（HER2）-]、8个月[HR+/HER2+]、7个月[HR-/HER2+]和2个月[三阴性乳腺癌（TNBC）]。全脑放疗（WBRT）（n = 48，70%）是最常用的治疗方法，其次是手术（n = 15，22%）和立体定向放射外科手术（n = 6，8%）。在仅接受WBRT的患者（n = 40）中，WBRT后的中位OS为2.6个月。
发生BM后，一半的患者接受了全身治疗，70%的患者接受了局部治疗，但只有HER2亚组的OS延长，这可能反映了抗HER2药物的中枢神经系统（CNS）活性。TNBC患者的预后最差。虽然我们的队列规模较小，但60%在发生BM后接受曲妥珠单抗 emtansine治疗的HER2+患者的OS超过1年，这对于抗体药物偶联物和CNS活性来说是令人鼓舞的。接受WBRT的患者CNS疾病负担更高，OS不到3个月。
