Breast cancer subtype predicts clinical outcomes after stereotactic radiation for brain metastases

Purpose We investigated the prognostic ability of tumor subtype for patients with breast cancer brain metastases (BCBM) treated with stereotactic radiation (SRT). Methods This is a retrospective review of 181 patients who underwent SRT to 664 BCBM from 2004 to 2019. Patients were stratified by subty...

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Bibliographic Details
Published in:Journal of neuro-oncology 2021-05, Vol.152 (3), p.591-601
Main Authors: Mills, Matthew N., Thawani, Chetna, Figura, Nicholas B., Oliver, Daniel E., Soyano, Aixa E., Etame, Arnold, Robinson, Timothy J., Liu, James K., Vogelbaum, Michael A., Forsyth, Peter A., Czerniecki, Brian J., Soliman, Hatem H., Han, Hyo S., Yu, Hsiang-Hsuan Michael, Ahmed, Kamran A.
Format: Article
Language:English
Subjects:
Brain cancer
Brain Neoplasms - radiotherapy
Brain Neoplasms - secondary
Brain Neoplasms - surgery
Breast cancer
Breast Neoplasms - radiotherapy
Clinical outcomes
Clinical Study
ErbB-2 protein
Female
Humans
Medicine
Medicine & Public Health
Metastases
Metastasis
Multivariate analysis
Neurology
Oncology
Radiation therapy
Radiosurgery
Retrospective Studies
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Summary:Purpose We investigated the prognostic ability of tumor subtype for patients with breast cancer brain metastases (BCBM) treated with stereotactic radiation (SRT). Methods This is a retrospective review of 181 patients who underwent SRT to 664 BCBM from 2004 to 2019. Patients were stratified by subtype: hormone receptor (HR)-positive, HER2-negative (HR+/HER2−), HR-positive, HER2-positive (HR+/HER2+), HR-negative, HER2-positive (HR−/HER2+), and triple negative (TN). The Kaplan–Meier method was used to calculate overall survival (OS), local control (LC), and distant intracranial control (DIC) from the date of SRT. Multivariate analysis (MVA) was conducted using the Cox proportional hazards model. Results Median follow up from SRT was 11.4 months. Of the 181 patients, 47 (26%) were HR+/HER2+, 30 (17%) were HR−/HER2+, 60 (33%) were HR+/HER2−, and 44 (24%) were TN. Of the 664 BCBMs, 534 (80%) received single fraction stereotactic radiosurgery (SRS) with a median dose of 21 Gy (range 12–24 Gy), and 130 (20%) received fractionated stereotactic radiation therapy (FSRT), with a median dose of 25 Gy (range 12.5–35 Gy) delivered in 3 to 5 fractions. One-year LC was 90%. Two-year DIC was 35%, 23%, 27%, and 16% (log rank, p  = 0.0003) and 2-year OS was 54%, 47%, 24%, and 12% (log rank, p  
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-021-03735-5