Zümrüt BAHAT, Özlem AYNACI, Vildan ALTUNAYOGLU CAKMAK, Ertuğrul ÇAKIR, Mustafa KANDAZ, Serdar ÖZKÖK

İKİ RADYOREZİSTAN TÜMÖR OLAN MALİGN MELANOM VE RENAL HÜCRELİ KARSİNOMUN BEYİN METASTAZLARININ ÖZELLİKLERİ VE SAĞKALIMLA İLİŞKİLERİ: BİR RADYOTERAPİ MERKEZİ ÇALIŞMASI

Amaç: Malign melanom (MM) ve renal hücreli karsinom (RCC), beyne sıklıkla metastaz yapan nadir ve radyorezistan tümörlerdir. Nadir olmaları nedeniyle beyin metastatik MM ve RCC ile ilgili çalışmalar sınırlıdır. MM ve RCC kaynaklı beyin metastazı (BM) gelişen hastaların karakteristik özelliklerini ve sağkalım için potansiyel prognostik faktörleri analiz etmeyi amaçladık. Gereç ve Yöntem: Bu çalışma, 1998-2020 yılları arasında bir üniversite hastanesinin radyoterapi (RT) merkezine başvuran hastaların verilerini kullanan geriye dönük-gözlemsel bir çalışmadır. Klinikopatolojik özellikler, tedavi detayları ve sonlanım verileri analiz edildi. Tek değişkenli analizler ve çok değişkenli sağkalım analizleri yapıldı. Bulgular: Çalışma döneminde merkezimizde tedavi edilen toplam 14,603 hastadan sadece 52’si (%0,004) MM veya RCC ilişkili BM vakasıydı. Çalışma popülasyonunu verileri eksiksiz olan 40 hasta oluşturmaktaydı. MM veya RCC ilişkili BM tanısında medyan yaş 57,7 olup, hastaların %25’i kadındı. MM sıklığı %52,5 ve RCC sıklığı %47,5 idi. “Primer tanı ile ilk ekstrakraniyal metastazlar arasındaki süre” ile “ekstrakraniyal metastaz tanısı ile BM arasındaki süre” arasında zayıf bir korelasyon vardı (r=0,405, p=0,021). Sağkalıma yönelik potansiyel prognostik faktörler olan “yaş, cinsiyet, yaşlı veya genç olma, primer tanı (MM veya RCC olması), ekstrakraniyal metastaz varlığı, BM sayısı, BM’nin yeri, tam yada tama yakın rezeksiyon, RT dozu, planlanan RT’nin tamamlanması, RT alanı” gibi parametrelerin hiçbiri sağkalım ile bağımsız ilişkili değildi. Sonuç: Bulgularımız, MM veya RCC hastalarında beyin metastazı geliştirdiğinde hastaya, tümöre veya tedavi tercihine ait herhangi bir olumlu prognostik faktör olmadan sağkalımın sınırlı olduğunu göstermektedir.

Anahtar Kelimeler:

beyin metastazı, malign melanom, radyorezistan tümör, renal hücreli karsinom, sağkalım

CHARACTERISTICS AND SURVIVAL OF BRAIN METASTASIS FROM TWO RADIORESISTANT TUMORS, MALIGNANT MELANOMA AND RENAL CELL CARCINOMA: A SINGLE RADIOTHERAPY CENTER STUDY

Objective: Malignant melanoma (MM) and renal cell carcinoma (RCC) are rare radioresistant tumors that often metastasize to the brain. Because of their rarity, studies on brain metastatic RCC and MM are limited. We aimed to outline the characteristics of brain metastasis (BM) patients from RCC and MM and analyze the potential prognostic factors for survival. Materials and Methods: This is a retrospective-observational study using data from patients admitted to a radiotherapy (RT) center of a university hospital between 1998-2020. Clinicopathological characteristics, treatment details, and outcome results were analyzed. Univariate and multivariate survival analyses were performed. Results: Among a total of 14,603 patients treated in our center in the study period, only 52 (0.004%) were BM cases from MM or RCC. Forty patients had complete data (median age at diagnosis of MM or RCC-related BM: 57.7; females: 25%; MM in 52.5% and RCC in 47.5%). The time between primary diagnosis and first extracranial metastases was weakly correlated with the time between diagnosis of extracranial metastasis and BM (r=0.405, p=0.021). Among the potential prognostic factors on survival [age, sex, older vs younger age group, primary diagnosis (MM vs RC), presence of extracranial metastasis, number of BM, location of BM, presence of gross total resection, dose of RT, completion of prescribed RT, field of RT], none were independently associated with survival. Conclusion: Our findings suggest that when MM or RCC patients develop brain metastasis, survival is limited without any favorable prognostic factor belonging to the patient, the tumor, or the preference of the treatment.

Keywords:

brain metastasis, malignant melanoma, radioresistant tumor, renal cell cancer, survival,

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