Diagnosis and Treatment of Brain Metastases in Patients with Gynecologic Malignancies: A Nationwide Analysis

2020 ◽  
Vol 158 (1) ◽  
pp. e11-e12
Author(s):  
R. Wegner ◽  
J. Bergin ◽  
Z. Horne
2021 ◽  
pp. ijgc-2021-002906
Author(s):  
Eva Meixner ◽  
Tanja Eichkorn ◽  
Sinem Erdem ◽  
Laila König ◽  
Kristin Lang ◽  
...  

IntroductionStereotactic radiosurgery is a well-established treatment option in the management of brain metastases. Multiple prognostic scores for prediction of survival following radiotherapy exist, but are not disease-specific or validated for radiosurgery in women with primary pelvic gynecologic malignancies metastatic to the brain. The aim of the present study is to evaluate the feasibility, safety, outcomes, and impact of established prognostic scores.MethodsWe retrospectively identified 52 patients treated with radiotherapy for brain metastases between 2008 and 2021. Stereotactic radiosurgery was utilized in 31 patients for an overall number of 75 lesions; the remaining 21 patients received whole-brain radiotherapy. Kaplan-Meier survival analysis and the log-rank test were used to calculate and compare survival curves and univariate and multivariate Cox regression to assess the influence of cofactors on recurrence, local control, and prognosis.ResultsWith a median follow-up of 10.7 months, overall survival rates post radiosurgery were 65.3%, 51.3%, and 27.7% for 1, 2, and 5 years, respectively, which were significantly higher than post whole-brain radiotherapy (p=0.049). Five local failures (6.7%) were detected, resulting in 1 and 2 year local cerebral control rates of 97.4% and 94.0%, respectively. Univariate factors for prediction of superior overall survival were high performance status (p=0.030) and application of three prognostic scores, especially the Recursive Partitioning Analysis score (p=0.028). Uni- and multivariate analysis revealed that extracranial progression prior to radiosurgery was significant for inferior overall survival (p<0.0001). Radionecrosis was diagnosed in five women (16%); long-term neurotoxicity was significantly worse after whole-brain radiotherapy compared with radiosurgery (p=0.023).ConclusionStereotactic radiosurgery for brain metastases from pelvic gynecologic malignancies appears to be safe and well tolerated, achieving promising local cerebral control. Prognostic scores were shown to be transferable and radiosurgery should be recommended as primary intracranial treatment, especially in women with no prior extracranial progression and Recursive Partitioning Analysis class I.


Author(s):  
JM Saunus ◽  
M Lim ◽  
S Puttick ◽  
P Kalita-de Croft ◽  
ZH Houston ◽  
...  

2020 ◽  
Vol 34 ◽  
pp. 100664
Author(s):  
Kristen Cagino ◽  
Ryan Kahn ◽  
Susan Pannullo ◽  
Hani Ashamalla ◽  
Susie Chan ◽  
...  

2020 ◽  
Vol 43 (6) ◽  
pp. 418-421
Author(s):  
Dimitrios Nasioudis ◽  
Anitra Persaud ◽  
Neil K. Taunk ◽  
Nawar A. Latif

2018 ◽  
Vol 36 (5) ◽  
pp. 483-491 ◽  
Author(s):  
Paul D. Brown ◽  
Manmeet S. Ahluwalia ◽  
Osaama H. Khan ◽  
Anthony L. Asher ◽  
Jeffrey S. Wefel ◽  
...  

An estimated 20% of patients with cancer will develop brain metastases. Approximately 200,000 individuals in the United States alone receive whole-brain radiotherapy (WBRT) each year to treat brain metastases. Historically, the prognosis of patients with brain metastases has been poor; however, with new therapies, this is changing. Because patients are living longer following the diagnosis and treatment of brain metastases, there has been rising concern about treatment-related toxicities associated with WBRT, including neurocognitive toxicity. In addition, recent clinical trials have raised questions about the use of WBRT. To better understand this rapidly changing landscape, this review outlines the treatment roles and toxicities of WBRT and alternative therapies for the management of brain metastases.


2011 ◽  
Vol 105 (1) ◽  
pp. 109-118 ◽  
Author(s):  
Maximilian I. Ruge ◽  
Philipp Kickingereder ◽  
Stefan Grau ◽  
Mauritius Hoevels ◽  
Harald Treuer ◽  
...  

CNS Oncology ◽  
2014 ◽  
Vol 3 (3) ◽  
pp. 209-217 ◽  
Author(s):  
Anna Minchom ◽  
Ken C Yu ◽  
Jaishree Bhosle ◽  
Mary O'Brien

2017 ◽  
Vol 19 (2) ◽  
pp. 162-174 ◽  
Author(s):  
Riccardo Soffietti ◽  
Ufuk Abacioglu ◽  
Brigitta Baumert ◽  
Stephanie E. Combs ◽  
Sara Kinhult ◽  
...  

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