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Novel prognostic classification predicts overall survival of patients receiving salvage whole-brain radiotherapy for recurrent brain metastasis from breast cancer: A recursive partitioning analysis (KROG 16-12)

Title
Novel prognostic classification predicts overall survival of patients receiving salvage whole-brain radiotherapy for recurrent brain metastasis from breast cancer: A recursive partitioning analysis (KROG 16-12)
Authors
Kim J.S.Kim K.Jung W.Shin K.H.Im S.-A.Kim Y.B.Chang J.S.Choi D.H.Kim H.Park Y.H.Kim D.Y.Kim T.H.Kwon J.Kang K.M.Chung W.-K.Kim K.S.Kim I.A.
Ewha Authors
김경수
SCOPUS Author ID
김경수scopus
Issue Date
2021
Journal Title
Breast
ISSN
0960-9776JCR Link
Citation
Breast vol. 60, pp. 272 - 278
Keywords
Brain metastasisBreast cancerOverall survivalRecursive partitioning analysisWhole-brain radiotherapy
Publisher
Churchill Livingstone
Indexed
SCIE; SCOPUS scopus
Document Type
Article
Abstract
Background: To investigate outcomes of salvage whole-brain radiotherapy (WBRT) for recurrent brain metastases (BM) from breast cancer (BC), to identify prognostic factors of overall survival (OS), and to propose a novel prognostic classification for OS in these patients. Materials and methods: We identified 54 patients who had received salvage WBRT as the second brain-focused treatment for recurrent BM from BC (2000–2014). The median follow-up duration was 4.9 months. A recursive partitioning analysis (RPA) was conducted to develop a model to predict OS at the time of salvage WBRT. Results: The median OS was 6.8 months. OS according to BC-specific graded prognostic assessment (breast-GPA), modified breast-GPA, and updated breast-GPA did not represent our cohort. In the multivariate analysis, a long time before salvage WBRT (≥16 months), control of primary BC or extracranial metastases, systemic treatment after salvage WBRT, and administration of a biologically effective dose for an α/β of 10 Gy (BED10) of salvage WBRT >37.5 Gy showed superior OS. We proposed three RPA classes based on the control of both primary BC and extracranial metastasis and BED10 of salvage WBRT: class I, class II, and class III. In this model, patients with class I experienced the best OS (34.6 months; class II, 5.0 months; class III, 2.4 months; P < 0.001). Conclusions: In our RPA classification according to the control of both primary BC and extracranial metastasis and the dose of salvage WBRT, significant differences in OS were observed. The subsequent use of a systemic treatment showed better OS. © 2021 The Authors
DOI
10.1016/j.breast.2021.11.005
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의료원 > 의료원 > Journal papers
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