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)

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 id...

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Autores principales:	Jae Sik Kim, Kyubo Kim, Wonguen Jung, Kyung Hwan Shin, Seock-Ah Im, Yong Bae Kim, Jee Suk Chang, Doo Ho Choi, Haeyoung Kim, Yeon Hee Park, Dae Yong Kim, Tae Hyun Kim, Jeanny Kwon, Ki Mun Kang, Woong-Ki Chung, Kyung Su Kim, In Ah Kim
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Breast cancer Brain metastasis Whole-brain radiotherapy Overall survival Recursive partitioning analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/53f61f99e67f421cb56f5690fca6d40b
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spelling	oai:doaj.org-article:53f61f99e67f421cb56f5690fca6d40b2021-11-22T04:18:06ZNovel 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)1532-308010.1016/j.breast.2021.11.005https://doaj.org/article/53f61f99e67f421cb56f5690fca6d40b2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0960977621009875https://doaj.org/toc/1532-3080Background: 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.Jae Sik KimKyubo KimWonguen JungKyung Hwan ShinSeock-Ah ImYong Bae KimJee Suk ChangDoo Ho ChoiHaeyoung KimYeon Hee ParkDae Yong KimTae Hyun KimJeanny KwonKi Mun KangWoong-Ki ChungKyung Su KimIn Ah KimElsevierarticleBreast cancerBrain metastasisWhole-brain radiotherapyOverall survivalRecursive partitioning analysisNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENBreast, Vol 60, Iss , Pp 272-278 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Breast cancer Brain metastasis Whole-brain radiotherapy Overall survival Recursive partitioning analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Breast cancer Brain metastasis Whole-brain radiotherapy Overall survival Recursive partitioning analysis Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jae Sik Kim Kyubo Kim Wonguen Jung Kyung Hwan Shin Seock-Ah Im Yong Bae Kim Jee Suk Chang Doo Ho Choi Haeyoung Kim Yeon Hee Park Dae Yong Kim Tae Hyun Kim Jeanny Kwon Ki Mun Kang Woong-Ki Chung Kyung Su Kim In Ah Kim 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)
description	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.
format	article
author	Jae Sik Kim Kyubo Kim Wonguen Jung Kyung Hwan Shin Seock-Ah Im Yong Bae Kim Jee Suk Chang Doo Ho Choi Haeyoung Kim Yeon Hee Park Dae Yong Kim Tae Hyun Kim Jeanny Kwon Ki Mun Kang Woong-Ki Chung Kyung Su Kim In Ah Kim
author_facet	Jae Sik Kim Kyubo Kim Wonguen Jung Kyung Hwan Shin Seock-Ah Im Yong Bae Kim Jee Suk Chang Doo Ho Choi Haeyoung Kim Yeon Hee Park Dae Yong Kim Tae Hyun Kim Jeanny Kwon Ki Mun Kang Woong-Ki Chung Kyung Su Kim In Ah Kim
author_sort	Jae Sik Kim
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)
title_short	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_full	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_fullStr	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_full_unstemmed	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_sort	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)
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/53f61f99e67f421cb56f5690fca6d40b
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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)

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