Results of Whole Brain Radiation Therapy in Breast Cancer Patients with Brain Metastases

Diana Stripp, MD
University of Pennsylvania Cancer Center
Last Modified: November 7, 2001

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Presenter: A.S. Mahmoud-ahmed
Presenter's Affiliation: Radiation Oncology, Cleveland Clinic Foundation, Cleveland, OH
Type of Session: Scientific

Background

  • Brain metastasis is the most common neurologic complication experienced breast cancer patients.
  • Whole brain irradiation is a known methods of palliation for these lesions.
  • Some previous studies have shown improved survival for patients treated with stereotatic radiotherapy in addition to WBRT.

    Materials and Methods

  • Retrospective review of 116 pts with breast cancer who were treated with WBRT, 2/84- 9/00.
  • Evaluation of the significance of age, stage of the primary, control of the primary, presence of other systemic metastases, site of systemic metastases, KPS, RPA class, total dose of WBRT and number of the brain metastases in predicting the survival after WBRT in these patients.
  • 60 patients had follow up scans after WBRT.

    Results

  • The median survival was 4.2 months.
  • The 1-year survival rate was 17% and the 2-year survival was only 2%.
  • Local control was 50%.
  • Multivariate analysis showed that only KPS, RPA and whether WBRT was given are the significant prognostic factors.

    Author's Conclusions

  • Overall survival in breast cancer patients with brain metastases treated with WBRT was poor.
  • Only predictors of longer survival in this study were KPS, RPA class and higher radiation dose

    Clinical/Scientific Implications

  • In selected population of patients, addition of SRS boost to WBRT appears to be a feasible palliative measures in pts with breast cancer with brain metastases.
  • Prospective studies have not shown a benefit to SRS in patients with multiple brain mets.
  • Further evaluation is needed specifically in patients with a single brain met, particularly in those patients with breast cancer which has such a long natural history compared to other cancers.

    Oncolink's ASTRO Coverage made possible by an unrestricted Educational Grant from Bristol-Myers Squibb Oncology and Pharmacia Oncology.