scholarly journals Is Whole Brain Radiotherapy Enough for Palliative Care of Patients with Infratentorial Brain Metastases from Lung or Breast Cancer?

2020 ◽  
Author(s):  
Bernardo Cacho-Díaz ◽  
Alejandra Alvarez-Alvarez ◽  
Karen Salmerón-Moreno ◽  
Oscar Rodríguez-Mayoral ◽  
Bernardino Gabriel Santiago-Concha ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Median Overall Survival ◽  
Whole Brain Radiotherapy ◽  
Newly Diagnosed ◽  
Single Center ◽  
Whole Brain ◽  
Systemic Activity ◽  
Brain Radiotherapy ◽  
Significant Difference

Abstract Background: Brain metastases (BM) occur in almost one third of patients with solid tumors. The aim of the study was to compare the prognosis of patients treated with whole brain radiotherapy (WBRT) among patients with supra- or infratentorial lesions.Material and Methods: At a single center, 263 patients with either breast (BC) or lung (LC) cancer, that developed BM and received treatment with WBRT, were analyzed during an 8-year period.Results: A total of 152 patients with BC and 111 with LC were analyzed, median age at the time of BM was 50.7 years, systemic activity other than BM was detected in 91%. Newly diagnosed BM were supratentorial and infratentorial in 133 patients (51%); exclusively supratentorial in 105 patients (40%); and exclusively infratentorial in 10%. Globally, 238 patients (90%) had supratentorial lesions, and 158 (60%) had infratentorial lesions. Median overall survival was 13 months (95%CI 11.1-14.8 months), without significant difference between supra- or infratentorial location.Conclusion: In patients with LC or BC that develop BM, palliative WBRT is equally effective in those with supra- or infratentorial locations.

scholarly journals A Case of Brain Metastases from Breast Cancer Treated with Whole-Brain Radiotherapy and Eribulin Mesylate

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Carsten Nieder ◽  
Gro Aandahl ◽  
Astrid Dalhaug
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Metastatic Disease ◽  
Local Treatment ◽  
Whole Brain Radiotherapy ◽  
Maximum Size ◽  
Newly Diagnosed ◽  
Eribulin Mesylate ◽  
Whole Brain ◽  
Brain Radiotherapy

Patients with triple receptor-negative breast cancer often develop aggressive metastatic disease, which also might involve the brain. In many cases, systemic and local treatment is needed. It is important to consider the toxicity of chemo- and radiotherapy, especially when newly approved drugs become available. Randomised studies leading to drug approval often exclude patients with newly diagnosed brain metastases. Here we report our initial experience with eribulin mesylate and whole-brain radiotherapy (WBRT) in a heavily pretreated patient with multiple brain, lung, and bone metastases from triple receptor-negative breast cancer. Eribulin mesylate was given after 4 previous lines for metastatic disease. Two weeks after the initial dose, that is, during the first cycle, the patient was diagnosed with 5 brain metastases with a maximum size of approximately 4.5 cm. She continued chemotherapy and received concomitant WBRT with 10 fractions of 3 Gy. After 3 cycles of eribulin mesylate, treatment was discontinued because of newly diagnosed liver metastases and progression in the lungs. No unexpected acute toxicity was observed. The only relevant adverse reactions were haematological events after the third cycle (haemoglobin 9.5 g/dL, leukocytes3.1×109/L). The patient died from respiratory failure 18.5 months from diagnosis of metastatic disease, and 2.7 months from diagnosis of brain metastases. To the best of our knowledge, this is the first report on combined WBRT and eribulin mesylate.

Concurrent capecitabine and whole-brain radiotherapy for treatment of brain metastases in breast cancer patients

2009 ◽  
Vol 93 (3) ◽  
pp. 379-384 ◽  
Author(s):  
Cyrus Chargari ◽  
◽  
Youlia M. Kirova ◽  
Véronique Diéras ◽  
Pablo Castro Pena ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Whole Brain Radiotherapy ◽  
Breast Cancer Patients ◽  
Whole Brain ◽  
Brain Radiotherapy

scholarly journals Do patients with very few brain metastases from breast cancer benefit from whole-brain radiotherapy in addition to radiosurgery?

2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Dirk Rades ◽  
Stefan Huttenlocher ◽  
Dagmar Hornung ◽  
Oliver Blanck ◽  
Steven E Schild ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Whole Brain Radiotherapy ◽  
Whole Brain ◽  
Brain Radiotherapy

scholarly journals Clinical outcomes in patients with brain metastases from breast cancer treated with single-session radiosurgery or whole brain radiotherapy

2016 ◽  
Vol 125 (Supplement_1) ◽  
pp. 26-30 ◽  
Author(s):  
Michael Mix ◽  
Rania Elmarzouky ◽  
Tracey O'Connor ◽  
Robert Plunkett ◽  
Dheerendra Prasad
Keyword(s):  
Breast Cancer ◽  
Brain Metastases ◽  
Median Survival ◽  
Tumor Volume ◽  
Whole Brain Radiotherapy ◽  
Metastatic Tumor ◽  
Whole Brain ◽  
Receptor Status ◽  
Brain Radiotherapy ◽  
Her 2

OBJECTIVEGamma Knife radiosurgery (GKRS) is used to treat brain metastases from breast cancer (BMB) as the sole treatment or in conjunction with tumor resection and/or whole brain radiotherapy (WBRT). This study evaluates outcomes in BMB based on treatment techniques and tumor biological features.METHODSThe authors reviewed all patients treated with BMB between 2004 and 2014. Patients were identified from a prospectively collected radiosurgery database and institutional tumor registry; 214 patients were identified. Data were collected from aforementioned sources and supplemented with chart review where needed. Independent radiological review was performed for all available brain imaging in those treated with GKRS. Survival analyses are reported using Kaplan-Meier estimates.RESULTSDuring the 10-year study period, 214 patients with BMB were treated; 23% underwent GKRS alone, 46% underwent a combination of GKRS and WBRT, and 31% underwent WBRT alone. Median survival after diagnosis of BMB in those treated with GKRS alone was 21 months, and in those who received WBRT alone it was 3 months. In those treated with GKRS plus WBRT, no significant difference in median survival was observed between those receiving WBRT upfront or in a salvage setting following GKRS (19 months vs 14 months, p = 0.63). The median survival of patients with total metastatic tumor volume of ≤ 7 cm3 versus > 7 cm3 was 20 months vs 7 months (p < 0.001). Human epidermal growth factor receptor-2 (Her-2) positively impacted survival after diagnosis of BMB (19 months vs 12 months, p = 0.03). Estrogen receptor status did not influence survival after diagnosis of BMB. No difference was observed in survival after diagnosis of BMB based on receptor status in those who received WBRT alone.CONCLUSIONSIn this single-institution series of BMB, the addition of WBRT to GKRS did not significantly influence survival, nor did the number of lesions treated with GKRS. Survival after the diagnosis of BMB was most strongly affected by Her-2 positivity and total metastatic tumor volume.

Evaluation of Stereotactic Radiotherapy of the Resection Cavity After Surgery of Brain Metastases Compared to Postoperative Whole-Brain Radiotherapy (ESTRON)—A Single-Center Prospective Randomized Trial

Neurosurgery ◽  
2018 ◽  
Vol 83 (3) ◽  
pp. 566-573 ◽  
Author(s):  
Rami A El Shafie ◽  
Angela Paul ◽  
Denise Bernhardt ◽  
Henrik Hauswald ◽  
Thomas Welzel ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiotherapy ◽  
Randomized Study ◽  
Whole Brain Radiotherapy ◽  
Progression Free Survival ◽  
Locoregional Control ◽  
Single Center ◽  
Whole Brain ◽  
Resection Cavity ◽  
Brain Radiotherapy

Abstract BACKGROUND Neurosurgical resection is recommended for symptomatic brain metastases, in oligometastatic patients or for histology acquisition. Without adjuvant radiotherapy, roughly two-thirds of the patients relapse at the resection site within 24 mo, while the risk of new metastases in the untreated brain is around 50%. Adjuvant whole-brain radiotherapy (WBRT) can reduce the risk of both scenarios of recurrence significantly, although the associated neurocognitive toxicity is substantial, while stereotactic radiotherapy (SRT) improves local control at comparably low toxicity. OBJECTIVE To compare locoregional control and treatment-associated toxicity for postoperative SRT and WBRT after the resection of 1 brain metastasis in a single-center prospective randomized study. METHODS Fifty patients will be randomized to receive either hypofractionated SRT of the resection cavity and single- or multisession SRT of all unresected brain metastases (up to 10 lesions) or WBRT. Patients will be followed-up regularly and the primary endpoint of neurological progression-free survival will be assessed by magnetic resonance imaging (MRI). Quality of life and neurocognition will be assessed in 3-mo intervals using standardized tests and EORTC questionnaires. EXPECTED OUTCOMES We expect to show that postoperative SRT of the resection cavity and further unresected brain metastases is a valid means of improving locoregional control over observation at less neurocognitive toxicity than caused by WBRT. DISCUSSION The present study is the first to compare locoregional control as well as neurocognitive toxicity for postoperative SRT and WBRT in patients with up to 10 metastases, while utilizing a highly sensitive and standardized MRI protocol for treatment planning and follow-up.

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