Overview of Survival and Related Parameters in Malignancies with Brain Metastasis

Overview of Survival and Related Parameters in Malignancies with Brain Metastasis

OBJECTIVEBrain metastasis is the most common type of brain tumor. The present study is an investigation of prognosticfactors for survival in patients with brain metastasis.METHODSWe retrospectively investigated patients with brain metastasis who were treated at the Cumhuriyet Universitycenter for radiation oncology between 2006 and 2014.RESULTSThe data of 277 patients were analyzed. Age of the patient, performance status, length of time to metastasis,site of primary disease, and performance of metastasectomy were determined to be factors that affectprognosis. Independent prognostic factors were found to be: time to metastasis (hazard ratio [HR]: 0.72;95% confidence interval [CI]: 0.52-0.99; p=0.0047), performance status (HR: 1.40; 95% CI: 1.07-1.85;p=0.015), and metastasectomy (HR: 0.54; 95% CI: 0.33-0.89; p=0.017).CONCLUSIONSurvival rate was better in patients with breast cancer, longer time before metastasis, good performance,and those who had undergone metastasectomy. Therapeutic approaches should be planned with considerationthat patients exhibiting these characteristics might have more favorable therapeutic outcomes.

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  • 1. Owonikoko TK, Arbiser J, Zelnak A, Shu HK, Shim H, Robin AM, et al. Current approaches to the treatment of metastatic brain tumours. Nat Rev Clin Oncol. 2014;11(4):203,22.
  • 2. Patchell RA. The management of brain metastases. Cancer Treat Rev 2003;29(6):533–40.
  • 3. Campos S, Davey P, Hird A, Pressnail B, Bilbao J, Aviv RI, et al. Brain metastasis from an unknown primary, or primary brain tumour? A diagnostic dilemma. Curr Oncol 2009;16(1):62–6.
  • 4. Brem S, Panattil JG. An era of rapid advancement: diagnosis and treatment of metastatic brain cancer. Neurosurgery 2005;57(5 Suppl):5–9; discusssion 1–4.
  • 5. Gavrilovic IT, Posner JB. Brain metastases: epidemiology and pathophysiology. J Neurooncol 2008;75(1):5– 14.
  • 6. Rodrigues G, Bauman G, Palma D, Louie AV, Mocanu J, Senan S, et al. Systematic review of brain metastases prognostic indices. Pract Radiat Oncol 2013;3(2):101– 6.
  • 7. Rodrigues G, Gonzalez-Maldonado S, Bauman G, Senan S, Lagerwaard F. A statistical comparison of prognostic index systems for brain metastases af ter stereotactic radiosurgery or fractionated stereotactic radiation therapy. Clin Oncol (R Coll Radiol) 2013;25(4):227–35.
  • 8. Yamamoto M, Kawabe T, Higuchi Y, Sato Y, Nariai T, Watanabe S, et al. Validity of prognostic grading indices for brain metastasis patients undergoing repeat radiosurgery. World Neurosurg 2014;82:1242–9.
  • 9. Viani GA, da Silva LG, Stefano EJ. Prognostic indexes for brain metastases: which is the most powerful? Int J Radiat Oncol Biol Phys 2012;83(3):325–30.
  • 10.Suh JH. Stereotactic radiosurgery for the management of brain metastases. N Engl J Med 2010;362(12):1119– 27.
  • 11.Gaspar LE, Mehta MP, Patchell RA, Burri SH, Robinson PD, Morris RE, et al. The role of whole brain radiation therapy in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 2010;96(1):17–32.
  • 12.Kalkanis SN, Kondziolka D, Gaspar LE, Burri SH, Asher AL, Cobbs CS, et al. The role of surgical resection in the management of newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 2010;96(1):33,43.
  • 13.Nieder C, Nestle U, Walter K, Niewald M, Schnabel K. Dose/effect relationships for brain metastases. J Cancer Res Clin Oncol 1998;124(6):346–50.
  • 14.Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE. Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol 2004;22(14):2865,72.
  • 15.Nussbaum ES, Djalilian HR, Cho KH, Hall WA. Brain metastases. Histology, multiplicity, surgery, and survival. Cancer 1996;78(8):1781–8.
  • 16.Gaspar L, Scott C, Rotman M, Asbell S, Phillips T, Wasserman T, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 1997;37(4):745–51.
  • 17.Vivas JP, Sanchez CF, Cedres JM, Montufar SV, Garcia E. Brain metastases, survival and recursive partitioning analysis (RPA) our experience. Reports of Practical Oncology and Radiotherapy 2013;18:89–90.
  • 18.Nieder C, Grosu AL, Spanne O, Andratschke NH, Geinitz H. Brain metastases in patients under 50 years of age: retrospective analysis. Clin Exp Metastasis 2012;29(8):949–56.
  • 19.Jang RW, Caraiscos VB, Swami N, Banerjee S, Mak E, Kaya E, et al. Simple prognostic model for patients with advanced cancer based on performance status. J Oncol Pract 2014;10(5):335–41.
  • 20.Soffietti R, Cornu P, Delattre JY, Grant R, Graus F, Grisold W, et al. Brain metastases. In: Gilhus NE, Barnes MP, Brainin M (Ed). European Handbook of Neurological Management. 2nd ed. Oxford: Blackwell Publishing Ltd.; 2011. p. 437–45.
  • 21.Hall WA, Djalilian HR, Nussbaum ES, Cho KH. Longterm survival with metastatic cancer to the brain. Med Oncol 2000;17(4):279–86.
  • 22.Duransoy YK, Selcuki M, Gokce T, Duransoy A. Prognostic Factors in Metastatic Brain Tumors: Study of 62 Patients. J Neurol Sci 2012;29(4):732–43.
  • 23.Bonnette P, Puyo P, Gabriel C, Giudicelli R, Regnard JF, Riquet M, et al. Surgical management of non-small cell lung cancer with synchronous brain metastases. Chest 2001;119(5):1469–75.
  • 24.Billing PS, Miller DL, Allen MS, Deschamps C, Trastek VF, Pairolero PC. Surgical treatment of primary lung cancer with synchronous brain metastases. J Thorac
  • 25.Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ, et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 1990;322(8):494–500.
  • 26.Patchell RA, Tibbs PA, Regine WF, Dempsey RJ, Mohiuddin M, Kryscio RJ, et al. Postoperative radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 1998;280(17):1485–9.
  • 27.Vecht CJ, Haaxma-Reiche H, Noordijk EM, Padberg GW, Voormolen JH, Hoekstra FH, et al. Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery? Ann Neurol 1993;33(6):583– 90.
  • 28.Ferrara M, Bizzozzero L, Talamonti G, D’Angelo VA. Surgical treatment of 100 single brain metastases. Analysis of the results. J Neurosurg Sci 1990;34(3- 4):303–8.