The effect of tumor subtype on the time from primary diagnosis to development of brain metastases and survival in patients with breast cancer
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- 作者：Paul W. Sperduto (1) (19)
Norbert Kased (2)
David Roberge (3)
Samuel T. Chao (4)
Ryan Shanley (5)
Xianghua Luo (5) (6)
Penny K. Sneed (2) (7)
John Suh (4)
Robert J. Weil (7)
Ashley W. Jensen (8)
Paul D. Brown (9)
Helen A. Shih (10)
John Kirkpatrick (11)
Laurie E. Gaspar (12)
John B. Fiveash (13)
Veronica Chiang (14)
Jonathan P.S. Knisely (15)
Christina Maria Sperduto (16)
Nancy Lin (17)
Minesh Mehta (18) - 关键词：Breast cancer ; Brain metastases ; Prognosis ; Radiation therapy ; Stereotactic radiosurgery ; Estrogen ; Progesterone ; HER2 ; Graded prognostic assessment
- 刊名：Journal of Neuro-Oncology
- 出版年：2013
- 出版时间：May 2013
- 年：2013
- 卷：112
- 期：3
- 页码：467-472
- 全文大小：162KB
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12. Sperduto PW, Wang M, Robins HI, et al. A phase III trial of whole brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) alone versus WBRT & SRS with temozolamide or erlotinib for non-small cell lung cancer and 1-3 brain metastases: Radiation Therapy Oncology Group 0320. Int J Radiat Oncol Biol Phys. Available at http://dx.doi/10.1016/j.ijrobp.2012.11.042
13. Le Scodan R, Jouanneau L, Massard C (2011) Brain metastases from breast cancer: prognostic significance of HER-2 overexpression, effect of trastuzumab and cause of death. BMC Cancer 11:395 CrossRef
14. Sperduto PW, Chao ST, Sneed PK et al (2010) Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: A multi-institutional analysis of 4,259 patients. Int J Radiat Oncol Biol Phys 77:655-61 CrossRef
15. Sperduto PW, Berkey B, Gaspar LE et al (2008) A new prognostic index and comparison to three other indices for patients with brain metastases: an analysis of 1,960 patients in the RTOG database. Int J Radiat Oncol Biol Phys 70:510-14 CrossRef
16. Vas-Luis I, Ottesen RA, Hughes ME, et al (2012) Impact of hormone receptor status on patterns of recurrence and clinical outcomes among patients with human epdermal growth factor-2-positive breast cancer in the National Comprehensive Cancer Network: a prospective cohort study. Breast Cancer Res 14:R129 - 作者单位：Paul W. Sperduto (1) (19)
Norbert Kased (2)
David Roberge (3)
Samuel T. Chao (4)
Ryan Shanley (5)
Xianghua Luo (5) (6)
Penny K. Sneed (2) (7)
John Suh (4)
Robert J. Weil (7)
Ashley W. Jensen (8)
Paul D. Brown (9)
Helen A. Shih (10)
John Kirkpatrick (11)
Laurie E. Gaspar (12)
John B. Fiveash (13)
Veronica Chiang (14)
Jonathan P.S. Knisely (15)
Christina Maria Sperduto (16)
Nancy Lin (17)
Minesh Mehta (18)
1. Minneapolis Radiation Oncology, University of Minnesota Gamma Knife, Minneapolis, MN, USA
19. 560 S. Maple Street, Suite 10, Waconia, MN, 55387, USA
2. Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
3. Radiation Oncology, Notre Dame Hospital, University of Montreal, Montreal, QC, Canada
4. Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH, USA
5. Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
6. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
7. Department of Neurosurgery, Cleveland Clinic, Cleveland, OH, USA
8. Department of Radiation Oncology, Sanford Roger Maris Cancer Center, Fargo, ND, USA
9. MD Anderson Cancer Center, Houston, TX, USA
10. Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
11. Department of Radiation Oncology, Duke University Medical Center, Durham, NC, USA
12. Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
13. Radiation Oncology, University of Alabama Medical Center at Birmingham, Birmingham, AL, USA
14. Department of Neurosurgery, Yale University School of Medicine and Yale Cancer Center, New Haven, CT, USA
15. Department of Radiation Medicine, Hofstra University School of Medicine and North Shore-Long Island Jewish Health System, Manhasset, NY, USA
16. Dartmouth College, Hanover, NH, USA
17. Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA
18. University of Maryland School of Medicine, Baltimore, MD, USA - ISSN：1573-7373
文摘
Our group has previously published the Diagnosis-Specific Graded Prognostic Assessment (GPA) showing the prognostic factors associated with survival in patients with brain metastases (BM). The purpose of this study is to investigate the relationship of breast cancer subtype to the time interval from primary diagnosis (PD) to development of BM (TPDBM), number of BM at initial BM presentation and survival. We analyzed our previously described multi-institutional retrospective database of 865 breast cancer patients treated for newly-diagnosed BM from 1993 to 2010. Several factors found to be associated with survival were incorporated into the Breast-GPA, including tumor subtype. The GPA database was further analyzed to determine if the subtype correlated with the TPDBM, number of BM, and survival from PD. After exclusions for incomplete data, 383 patients remained eligible for analysis. The subtypes were approximated as follows: Luminal B: triple positive; HER2: HER2 positive/ER/PR negative; Luminal A; ER/PR positive/HER2 negative; Basal: triple negative. Patients with Basal (90), HER2 (119), Luminal B (98) and Luminal A (76) tumor subtypes had a median TPDBM of 27.5, 35.8, 47.4 and 54.4?months (p?<?0.01), median survival from PD of 39.6, 66.4, 90.3 and 72.7?months (p?<?0.01) and median survival from BM of 7.3, 17.9, 22.9 and 10.0?months (p?<?0.01), respectively. Tumor subtype is an important prognostic factor for survival in patients with breast cancer and BM. Although TPDBM is not an independent prognostic factor for survival (and thus not part of the Breast-GPA), the TPDBM does correlate with tumor subtype but does not correlate with the number of BM. Patients with Basal and HER2 tumor subtypes have short TPDBM. Prospective studies are needed to determine if screening brain MRIs are indicated in patients with Basal or HER2 subtypes.