Effect of chemotherapy on survival after whole brain radiation therapy for brain metastases: a single-center retrospective analysis.
Summary of "Effect of chemotherapy on survival after whole brain radiation therapy for brain metastases: a single-center retrospective analysis."
BACKGROUND AND
PURPOSE:
Whether chemotherapy for systemic disease affects survival of patients with brain metastases or not has not been elucidated before. We performed comprehensive analysis of patients with newly-diagnosed brain metastases primarily treated with whole brain radiation therapy (WBRT) alone. MATERIALS AND
METHODS:
Data from 134 patients with newly-diagnosed brain metastases primarily treated with WBRT from 2007 to 2008 was retrospectively reviewed. Univariate and multivariate analyses were performed to identify significant prognostic factors.
RESULTS:
Median survival time (MST) of this cohort from the start of WBRT was 5.7 months. MST of patients with RPA Class 1, 2 and 3 were 10.3, 7.8 and 2.2 months, respectively. Multivariate analysis revealed that karnofsky performance status (≥70, p < 0.0001), gender (female, p < 0.0001), activity of extracranial disease (stable, p = 0.015), time to develop brain metastasis (<3 months, p = 0.042) and use of chemotherapy after WBRT (multiple regimens, p < 0.0001) were independent prognostic factors for better survival.
CONCLUSIONS:
Systemic chemotherapy for chemo-responsive cancer prolongs survival despite the presence of treated brain metastases. Irradiated brain metastases will lose their prognostic significance in a large number of patients. Systemic chemotherapy will be a treatment of choice for patients who have systemic disease after WBRT for brain metastases. These results should be validated in the future prospective clinical trials.
Affiliation
Division of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan, hmayahar@ncc.go.jp.
Journal Details
This article was published in the following journal.
Name: Journal of cancer research and clinical oncology
ISSN: 1432-1335
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22441932
- DOI: http://dx.doi.org/10.1007/s00432-012-1198-y
Medical and Biotech [MESH] Definitions
Chemotherapy, Adjuvant
Drug therapy given to augment or stimulate some other form of treatment such as surgery or radiation therapy. Adjuvant chemotherapy is commonly used in the therapy of cancer and can be administered before or after the primary treatment.
Neoadjuvant Therapy
Preliminary cancer therapy (chemotherapy, radiation therapy, hormone/endocrine therapy, immunotherapy, hyperthermia, etc.) that precedes a necessary second modality of treatment.
Salvage Therapy
A therapeutic approach, involving chemotherapy, radiation therapy, or surgery, after initial regimens have failed to lead to improvement in a patient's condition. Salvage therapy is most often used for neoplastic diseases.
Karnofsky Performance Status
A performance measure for rating the ability of a person to perform usual activities, evaluating a patient's progress after a therapeutic procedure, and determining a patient's suitability for therapy. It is used most commonly in the prognosis of cancer therapy, usually after chemotherapy and customarily administered before and after therapy. It was named for Dr. David A. Karnofsky, an American specialist in cancer chemotherapy.
Second-look Surgery
A followup operation to examine the outcome of the previous surgery and other treatments, such as chemotherapy or radiation therapy.
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