Stereotactic Radiosurgery Reasonable for Brain Mets

Overall survival >9 months after brain mets treated with salvage SRS in breast cancer

FRIDAY, Sept. 23 (HealthDay News) -- Salvage stereotactic radiosurgery (SRS) is a reasonable treatment for breast cancer brain metastases, with a median overall survival (OS) of more than nine months, according to a study published online Sept. 14 in Cancer.

Paul J. Kelly, M.B., from the Dana-Farber/Brigham and Women's Cancer Center in Boston, and colleagues evaluated clinical outcomes and prognostic factors for survival in 79 breast cancer patients receiving salvage SRS, of whom 76 had previously received whole-brain radiation therapy. Prognostic factors were assessed, and OS and central nervous system (CNS) progression-free survival rates from the SRS date were calculated.

The investigators found that 58, 62, and 10 percent of the patients were estrogen receptor positive, HER2 positive, and triple negative, respectively. Extracranial metastases were found in 95 percent of patients at the time of SRS. Of the extracranial metastases, 81 percent were noted at other visceral sites. Stable extracranial disease occurred in 48 percent of the patients. There was an 8.4 month median interval from initial treatment for brain metastases to SRS. Median CNS progression-free survival following SRS and median OS were 5.7 and 9.8 months, respectively. Additional systemic therapy after SRS was administered to 82 percent of the evaluable patients. Significant prognostic factors for survival noted on multivariate analysis were HER2 and extracranial disease status (adjusted hazard ratios, 2.4 and 2.7, respectively).

"Salvage SRS for breast cancer brain metastases is a reasonable treatment option, given an associated median survival in excess of nine months," the authors write.

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