scholarly journals Emlőtumor intracranialis metasztázisainak eredményes szisztémás palliatív kemoterápiája

2016 ◽  
Vol 157 (45) ◽  
pp. 1809-1813 ◽  
Author(s):  
István Sipőcz ◽  
Tamás Pintér ◽  
Zoltán Skaliczky ◽  
Tamás Kullmann
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Systemic Chemotherapy ◽  
Whole Brain Radiotherapy ◽  
Neurological Status ◽  
Leptomeningeal Carcinomatosis ◽  
Cerebral Metastases ◽  
Intrathecal Methotrexate ◽  
Brain Radiotherapy ◽  
Methotrexate Chemotherapy

The authors present the history of two patients. The first patient, a 69-year-old woman was diagnosed with locally invasive triple negative breast cancer with pulmonary and cerebral metastases. Complete radiological remission of the clinically asymptomatic cerebral metastases was detected under systemic chemotherapy with carboplatin-docetaxel (75 mg/m2). Later, the patient received whole brain radiotherapy and a second line of chemotherapy. The overall survival was 20 months from the diagnosis of cerebral metastases with conservation of partial autonomy. The second patient, a 57-year-old woman was diagnosed as having hormone sensitive lobular breast cancer with leptomeningeal, lymphonodular and multiple osseal metastases. Before the appearance of the lymphonodular metastasis the patient received intrathecal methotrexate chemotherapy for the leptomeningeal carcinomatosis. Her neurological symptoms completely disappeared. At the onset of the lymphonodular metastasis systemic chemotherapy with ifosfamide (1000 mg/m2, D1–3) – etoposide (100 mg/m2, D1–3) was started allowing complete clinical remission of the lymphadenomegaly and stability of the asymptomatic neurological status. The overall survival was 13 months from the diagnosis of leptomeningeal carcinomatosis with conservation of autonomy. The two cases support potential efficacy of systemic chemotherapy for intracranial metastases of breast cancer. Orv. Hetil., 2016, 157(45), 1809–1813.

scholarly journals Survival time and prognostic factors after whole-brain radiotherapy of brain metastases from of breast cancer

2020 ◽  
Vol 9 (7) ◽  
pp. 205846012093874
Author(s):  
Yukinori Okada ◽  
Mariko Kobayashi ◽  
Mio Shinozaki ◽  
Tatsuyuki Abe ◽  
Yoshihide Kanemaki ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Brain Metastasis ◽  
Brain Metastases ◽  
Survival Time ◽  
Whole Brain Radiotherapy ◽  
Whole Brain ◽  
Overall Survival Time ◽  
Brain Radiotherapy ◽  
Contrast Enhanced

Background Breast cancer has a poor prognosis due to the high risk of distant metastasis. Purpose To identify the prognosticators of brain metastasis from breast cancer treated by whole-brain radiotherapy. Material and Methods We evaluated patients diagnosed with primary brain metastasis without carcinomatous meningitis from breast cancer and had undergone whole-brain radiotherapy as initial treatment between 1 January 2010 and 30 September 2019. We investigated associations between overall survival time from diagnosis using cranial contrast-enhanced magnetic resonance imaging (MRI)/computed tomography (CT) and the following parameters: (i) age; (ii) sex; (iii) time to appearance of brain metastasis; (iv) other metastasis at appearance of brain metastasis; (v) blood test; (vi) symptoms at time of brain metastasis; (vii) whole-brain radiotherapy dose; (viii) whether whole-brain radiotherapy was completed; (ix) course of chemo- or radiotherapy; (x) subtype; (xi) additional irradiation after whole-brain radiotherapy; (xii) pathology; and (xiii) imaging findings. Results We evaluated 29 consecutive female patients (mean age 55.2 ± 12.1 years). Median overall survival time after diagnosis on cranial contrast-enhanced MRI/CT was 135 days (range 16–2112 days). Multivariate stepwise analysis of the three parameters of lactate dehydrogenase, dose, and subtype identified the following significant differences: Hazard Ratio (HR) for dose (discontinued, 30 Gy/10 fractions, 31.5 Gy/11 fractions, 32.5 Gy/11 fractions, 37.5 Gy/15 fractions) was 0.08 (95% confidence interval [CI] 0.02–0.30, P < 0.01), and HR for subtype (luminal, HER2, triple-negative) was 2.70 (95% CI 1.16–6.243, P < 0.01). Conclusion HER2-type and 37.5 Gy/15 fractions are good prognostic factor after whole-brain radiotherapy in breast cancer with brain metastases.

Intrathecal methotrexate chemotherapy for leptomeningeal carcinomatosis

2012 ◽  
Vol 153 (35) ◽  
pp. 1385-1388
Author(s):  
Tamás Kullmann ◽  
Hélène Gauthier ◽  
Christine le Maignan ◽  
Andrea Szabó ◽  
Stéphane Culine
Keyword(s):  
Breast Cancer ◽  
Clinical Manifestations ◽  
Leptomeningeal Carcinomatosis ◽  
Meningeal Carcinomatosis ◽  
Intrathecal Methotrexate ◽  
Cytological Examination ◽  
Significant Survival ◽  
The Central Nervous System ◽  
Methotrexate Chemotherapy

Lung and breast cancer can give meningeal metastases. Clinical manifestations of leptomeningeal carcinomatosis include all forms of defect of the central nervous system depending on the localization of carcinomatous foci. Diagnosis is based on the detection of carcinomatous cells by the cytological examination of the cerebrospinal fluid. Without treatment the prognosis is limited to only some weeks or months. In case the meningeal carcinomatosis is related to breast cancer, intrathecal methotrexate chemotherapy may allow a significant survival benefit and improve the quality of life in about half of the patients. Orv. Hetil., 2012, 153, 1385–1388.

scholarly journals Efficacy and toxicity of whole brain radiotherapy in patients with multiple cerebral metastases from malignant melanoma

2012 ◽  
Vol 7 (1) ◽  
Author(s):  
Henrik Hauswald ◽  
Jan-Oliver Dittmar ◽  
Daniel Habermehl ◽  
Stefan Rieken ◽  
Florian Sterzing ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Whole Brain Radiotherapy ◽  
Cerebral Metastases ◽  
Whole Brain ◽  
Brain Radiotherapy

Stereotactic radiosurgery for brain metastases from pelvic gynecological malignancies: oncologic outcomes, validation of prognostic scores, and dosimetric evaluation

2021 ◽  
pp. ijgc-2021-002906
Author(s):  
Eva Meixner ◽  
Tanja Eichkorn ◽  
Sinem Erdem ◽  
Laila König ◽  
Kristin Lang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Recursive Partitioning ◽  
Whole Brain Radiotherapy ◽  
Prognostic Scores ◽  
Gynecologic Malignancies ◽  
Whole Brain ◽  
Brain Radiotherapy ◽  
Cerebral Control

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.

Sign in / Sign up

Export Citation Format

Share Document