Mustafa CENGİZ, Kadri ALTUNDAG, Mehmet ARTAC, Cem BORUBAN, Hüseyin GULYER, Tunç GÜLER

Evaluating the clinicopathologic characteristics and survival outcome of breast cancer patients with ısolated brain metastases after adjuvant treatment or at ınitial diagnosis

SSS metastazı meme kanserinin geç dönemlerinde ortaya çıkar. Klasik yaklaşım, semptomatik olunca tedavi etmektir. Adjuvan tedavi sonrası veya başlangıçta tanıda, yalnızca beyin metastazı olan hastaların, klinikopatolojik karekteristiklerini inceledik ve sağkalımı değerlendiridik. Yazarlar, retrospektif olarak iki üniversite hastanesinden 3600 meme kanserli hastayı değerlendirip, içlerinden sadece ve tek olarak beyin metastazlı olan 31 hastayı çalışmaya aldılar. ER, PR, cerbB2 durumu, T , N evresi , grad, adju van taksan, trastuzumab, hormonal tedaviler, trastuzumab ve palatinin beyin metastazından sonra kullanımı sağ kalımı etkileme di. Cerrahi ve tüm beyin ışınlaması cerbB2 negatif hastlarda, tüm beyin ışınlaması ise cerB2 pozitif hastlarda daha etkili olabilir. (p=0.06). Sağ kalım pre ve perimenapozallerde daha iyi olabilir. mOS pre ve perimenapozallerde 17.7 ay postmenapozallerde 10.3 ay bulundu. (p=0.06) Lapatinib izole beyin metastazlı hastlarda mOSı etkileyebilir. Bazı prognostic faktörler, hangi tadaviden, hangi hasta gurubunun faydalanacağını öngörmemizi sağlayabilir. Daha çok hasta içeren çalışmalara olan ihtiyaç açıktır.

Adjuvan tedavisonrasi veya tanıda izole beyin metastazı olan hastların klinkopatolojik karekteristikleri ve sağ kalımlarının değerlendirilmesi

CNS metastases usually appears late in the progression of metastatic breast cancer. Classical approach is evaluating and treating them when symptoms become evident. We evaluated the survival and described clinicopathologic characteristics of patients in whom the brain metastases after adjuvant treatment or at initial diagnosis are the first and the only side. Authors retrospec tively evaluated about 3600 patients with breast cancer treated in two university hospitals. In those 31 patients with first and only metastases to brain and no other metastases were evaluated. ER, PR, cerbB2 status T, N stage, grade, adjuvant taxane, trastuzumab, hormonal treatment, trastuzumab and platine use after brain metastases didn t effect the survival. Surgery and WBRT may be more effective in cerbB2 negative patients, WBRT in cerbB2 positive ones. (p=0.06). The survival outcome may be better in pre and perimenouposal women. The mOS of pre and perimenopausal, postmenopausal women were 17.7 months and 10.3 months respectively (p=0.06) and lapatinib may affect the mOS of patients with isolated brain metastases. Some prognostic factor may help us to foresee which group may benefit more from which treatment modality. The need for studies with larger groups of patients is obvious.

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