The Effect of Early Detection of Occult Brain Metastases in HER2-Positive Breast Cancer Patients on Survival and Cause of Death

Journal Article · Thu Jul 15 04:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.06.030· OSTI ID:21436083

Niwinska, Anna ^[1]; Tacikowska, Malgorzata ^[2]; Murawska, Magdalena ^[3]

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1. Department of Breast Cancer and Reconstructive Surgery, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)
2. Department of Radiology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)
3. Department of Biostatistics, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw (Poland)

Purpose: The aim of the study is to evaluate disease-free survival, survival from the detection of brain metastases, overall survival, and cause of death in patients with occult brain metastases (Group I) vs. patients with symptomatic brain metastases (Group II). Methods and Materials: In 80 HER2-positive breast cancer patients, treated with trastuzumab and cytostatic agents for metastatic disease, magnetic resonance imaging screening of the brain was performed, and in 29 patients (36%) occult brain metastasis was detected (Group I). Whole-brain radiotherapy was delivered to Group I. This first group was compared with 52 patients who had symptomatic brain metastases (Group II) and was treated the same way, at the same clinic, during the same time period. Results: Median disease-free survival was 17 months in Group I and 19.9 months in Group II (p = 0.58). The median time interval between the dissemination of the disease and the detection of occult or symptomatic brain metastases was 9 and 15 months, respectively (p = 0.11). When the brain metastases were detected, the median survival was 9 and 8.78 months, respectively (p = 0.80). The median overall survival was 53 and 51 months, respectively (p = 0.94). In the group with occult brain metastases (Group I) 16% of patients died because of progression within the brain. In the group with symptomatic brain metastases (Group II) the rate of cerebral death was 48% (p = 0.009). Conclusions: Whole-brain radiotherapy of occult brain metastases in HER2-positive breast cancer patients with visceral dissemination produces a three-fold decrease in cerebral deaths but does not prolong survival.

• OSTI ID: 21436083
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 77; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
DEATH
DETECTION
DIAGNOSTIC TECHNIQUES
DISEASES
GLANDS
MAMMARY GLANDS
MEDICINE
METASTASES
NEOPLASMS
NERVOUS SYSTEM
NMR IMAGING
NUCLEAR MEDICINE
ORGANS
RADIOLOGY
RADIOTHERAPY
SCREENING
SURVIVAL CURVES
THERAPY