Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Therapeutic Regimens and Prognostic Factors of Brain Metastatic Cancers

  • Song, Wen-Guang (Department of Radiotherapy and Chemotherapy, Workers' Hospital) ;
  • Wang, Yi-Feng (Department of Obstetrics and Gynecology, Workers' Hospital) ;
  • Wang, Rui-Lin (Department of Radiotherapy and Chemotherapy, Workers' Hospital) ;
  • Qu, Yin-E (Basic Medical College, Hebei Union University) ;
  • Zhang, Zhi (Department of Radiotherapy and Chemotherapy, Workers' Hospital) ;
  • Li, Guo-Zhong (Department of Radiotherapy and Chemotherapy, Workers' Hospital) ;
  • Xiao, Ying (Department of Radiotherapy and Chemotherapy, Workers' Hospital) ;
  • Fang, Fang (Department of Radiotherapy and Chemotherapy, Workers' Hospital) ;
  • Chen, Hong (Department of Radiotherapy and Chemotherapy, Workers' Hospital)
  • Published : 2013.02.28
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Abstract

Objective: This work aims to investigate the therapeutic regimen of brain metastatic cancers and the relationship between clinical features and prognosis. Methods: Clinical data of 184 patients with brain metastatic cancers were collected and analysed for the relationship between survival time and age, gender, primary diseases, quantity of brain metastatic foci, their position, extra cranial lesions, and therapeutic regimens. Results: The average age of onset was 59.1 years old. The median survival time (MST) was 15.0 months, and the patients with breast cancer as the primary disease had the longest survival time. Females had a longer survival time than males. Patients with meningeal metastasis had extremely short survival time. Those with less than 3 brain metastatic foci survived longer than patients with more than 3. The MST of patients receiving radiotherapy only and the patients receiving chemotherapy only were all 10.0 months while the MST of patients receiving combination therapy was 16.0 months. Multiple COX regression analysis demonstrated that gender, primary diseases, and quantity of brain metastatic foci were independent prognostic factors for brain metastatic cancers. Conclusions: Chemotherapy is as important as radiotherapy in the treatment of brain metastatic cancer. Combination therapy is the best treatment mode. Male gender, brain metastatic cancers originating in the gastrointestinal tract, more than 3 metastatic foci, and involvement of meninges indicate a worse prognosis.

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References

  1. Abd-El-Barr MM, Rahman M, Rao G (2011). Investigational therapies for brain metastases. Neurosurg Clin N Am, 22, 87-96. https://doi.org/10.1016/j.nec.2010.08.008
  2. Bradley KA, Mehta MP (2004). Management of brain metastases. Semin Oncol, 31, 693-701. https://doi.org/10.1053/j.seminoncol.2004.07.012
  3. Butowski N (2011). Medical management of brain metastases. Neurosurg Clin N Am, 22, 27-36. https://doi.org/10.1016/j.nec.2010.08.004
  4. De Angelis LM (2001). Brain Tumors. N Engl J Med, 344, 114-23. https://doi.org/10.1056/NEJM200101113440207
  5. Fabi A, Felici A, Metro G, et al (2011). Brain metastases from solid tumors: disease outcome according to type of treatment and therapeutic resources of the treating center. J Exp Clin Cancer Res, 30, 10. https://doi.org/10.1186/1756-9966-30-10
  6. Gaspar L, Scott C, Rotman M, et al (1997). Recursive partitioning analsis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys, 37, 745-51. https://doi.org/10.1016/S0360-3016(96)00619-0
  7. Gavrilovic IT, Posner JB (2005). Brain metastases: epidemiology and pathophysiology. J Neurooncol, 75, 5-14. https://doi.org/10.1007/s11060-004-8093-6
  8. Lagerwaard FJ, Levendag PC, Nowak PJ, et al (1999). Identification of prognostic factors in patients with brain metastases: a review of 1292 patients. Int J Radiat Oncol Biol Phys, 43, 795-803. https://doi.org/10.1016/S0360-3016(98)00442-8
  9. Lee DH, Han JY, Kim HT, et al (2008). Primary chemotherapy for newly diagnosed nonsmall cell lung cancer patients with synchronous brain metastases compared with whole-brain radiotherapy administered first: result of a randomized pilot study. Cancer, 113, 143-9. https://doi.org/10.1002/cncr.23526
  10. Matsunaga S, Shuto T, Suenaga J, Inomori S, Fujino H (2010). Gamma knife radiosurgery for central neurocytomas. Neurol Med Chir (Tokyo), 50, 107-13. https://doi.org/10.2176/nmc.50.107
  11. Mehta RC, Pike GB, Haros SP, Enzmann DR (1995). Central nervous system tumor, infection, and infarction, detection with gadolinium-enhanced magnetization transfer MR imaging. Radiology, 195, 41-6. https://doi.org/10.1148/radiology.195.1.7892492
  12. Meyers CA, Smith JA, Bezjak A, et al (2004). Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: results of a randomized phase III trial. J Clin Oncol, 22, 157-65.
  13. Moscetti L, Nelli F, Felici A, et al (2007). Up-front chemotherapy and radiation treatment in newly diagnosed nonsmall cell lung cancer with brain metastases: survey by Outcome Research Network for Evaluation of Treatment Results in Oncology. Cancer, 109, 274-81. https://doi.org/10.1002/cncr.22399
  14. Neuhaus T, Ko Y, Muller RP, et al (2009). A phase III trial of topotecan and whole brain radiation therapy for patients with CNS-metastases due to lung cancer. Br J Cancer, 100, 291-7. https://doi.org/10.1038/sj.bjc.6604835
  15. Newton HB (1999). Neurological complications of systemic cancer. Am Fam Phys, 59, 878-86.
  16. Pardridge WM (2005). The blood-brain barrier: bottleneck in brain drug development. NeuroRx, 2, 3-14. https://doi.org/10.1602/neurorx.2.1.3
  17. Patchell RA (2003). The management of brain metastases. Cancer Treat Rev, 29, 533-40. https://doi.org/10.1016/S0305-7372(03)00105-1
  18. Rades D, Pluemer A, Veninga T, Dunst J, Schild SE (2007). A boost in addition to whole-brain radiotherapy improves patient outcome after resection of 1 or 2 brain metastases in recursive partitioning analysis class 1 and 2 patients. Cancer, 110, 1551-9. https://doi.org/10.1002/cncr.22960
  19. Rahmathulla G, Toms SA, Weil RJ (2012). The Molecular Biology of Brain Metastasis. J Oncol, 2012, 16.
  20. Sundstrom JT, Minn H, Lertola KK, Nordman E (1998). Prognosis of patients treated for intracranial metastases with whole-brain irradiation. Ann Med, 30, 296-9. https://doi.org/10.3109/07853899809005858

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