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Prognostic factor analysis in patients with brain metastases from breast cancer: how can we improve the treatment outcomes?

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Abstract

Purpose

We conducted this study to analyze clinicopathologic features and treatment outcomes for various treatment modalities in breast cancer patients with brain metastases.

Patients and methods

Retrospective analysis was performed using medical records of patients who were diagnosed with metastatic brain tumors from breast cancer. The treatment modalities applied included whole-brain radiotherapy (WBRT), surgical resection, stereotactic radiosurgery (SRS) and systemic treatments such as chemotherapy and endocrine therapy.

Results

Among 125 female breast cancer patients with brain metastases, 87.2% had Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0–2. The median overall survival (OS) was 6.6 months (95% CI 3.9–9.2). A multivariate analysis using the Cox-regression test identified three risk factors; poor PS (P = 0.023), HER2 positivity (P = 0.013), and no additional systemic treatment (P = 0.006). Those patients who had no risk factors showed outstanding outcome (median OS 49 months). On the contrary, the patients who had all risk factors (poor PS with HER2 positive and did not receive additional systemic chemotherapy) showed dismal prognosis (median OS 2 months).

Conclusions

Our new classification according to the suggested risk factors for patients with metastatic brain tumor from breast cancer reflects particular characteristics of each subset of the patients with good prognostic capacity.

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Acknowledgments

Supported by a grant of the Korean Health 21 R&D Project, Ministry of Health & Welfare, Republic of Korea (0412-CR01-0704-0001).

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Authors and Affiliations

  1. Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, 135-710, Seoul, South Korea

    Byeong-Bae Park, Ji Eun Uhm, Sang Hoon Ji, Yeon Hee Park, Jin Seok Ahn & Young-Hyuck Im

  2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Eun Yoon Cho & Yoon La Choi

  3. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Do Hyun Nam & Jung Il Lee

  4. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Won Park & Seung Jae Huh

Authors
  1. Byeong-Bae Park
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  2. Ji Eun Uhm
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  3. Eun Yoon Cho
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  5. Sang Hoon Ji
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  8. Won Park
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  10. Yeon Hee Park
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  12. Young-Hyuck Im
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Corresponding author

Correspondence to Young-Hyuck Im.

Additional information

B.-B. Park and J. E. Uhm contributed equally to the work.

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Park, BB., Uhm, J.E., Cho, E.Y. et al. Prognostic factor analysis in patients with brain metastases from breast cancer: how can we improve the treatment outcomes?. Cancer Chemother Pharmacol 63, 627–633 (2009). https://doi.org/10.1007/s00280-008-0779-6

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  • DOI: https://doi.org/10.1007/s00280-008-0779-6

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