Stereotactic radiosurgery for brain metastases from primary breast cancer

Shoji Yomo1, Motohiro Hayashi2, Teruhisa Watayo3

1Saitama, Japan 2Tokyo, Japan 3Saitama Gamma Knife Center, San-Ai Hospital, Saitama, Japan

Keywords: breast cancer, gamma knife, brain metastasis, radiosurgery, outcome

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     Central nerve system metastases are a feared complication of breast cancer and are associated with poor prognosis. 
     The purpose of this study is to evaluate the effectiveness and limitations of stereotactic radiosurgery (SRS) in the treatment of intracranial metastasis from breast cancer.
     All breast cancer patients who received treatment were included in this study and imaging studies were available in 59 patients with 369 treated lesions.
     Outcomes were retrospectively reviewed in consecutive 63 women with a total of 478 tumors, who underwent Gamma Knife SRS for metastatic brain tumors between January 2009 and July 2011.  The actuarial survival and freedom from progression endpoints were calculated using the Kaplan-Meier method.
     15 patients had already had Whole brain radiation therapy and 7 patients had had craniotomy. The median tumor volume at GKS was 0.5 cm3 (range 0.1-31.5 cm3). The median margin dose was 20 Gy (range 12-22 Gy). The 1-, 2- and 3-year survival rates were 49, 28 and 21%, respectively. The half-, 1- and 2-year local control rates were 96, 82 and 75%, respectively. Statistical analysis revealed that absence of HER-2 overexpression, lower KPS, larger tumor volume and meningitis carcinomatosis had a negative impact on the survival time.
     This was a retrospective study.
     The results of the current study indicate that SRS is a feasible treatment option for selected patients with metastatic brain tumors from breast cancer.
     Results stratified by  the different hormone receptor subtypes will be important.


Project Roles:

S. Yomo (), M. Hayashi (), T. Watayo ()