(S047) Clinical Outcomes Following One or More Courses of Stereotactic Radiosurgery for Brain Metastases From Breast Cancer

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OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

SRS is effective in treating BMs from breast cancer, and multiple courses of SRS are feasible and safe in select patients. Since this population can have a prolonged survival, aggressive local treatment with SRS can lead to improved survival and prevention of neurologic deficits.

Paul Youn, MD, Michael Cummings, MD, James Bates, MD, Michael T. Milano, MD, PhD; Department of Radiation Oncology, University of Rochester

OBJECTIVE: Stereotactic radiosurgery (SRS) is a standard approach to treatment of brain metastases (BMs) that are limited in number and extent. Breast cancer patients with BMs may experience prolonged survival and develop recurrent BMs. We examined a cohort of patients with BMs from breast cancer treated with SRS, focusing on long-term survivors at risk of distant brain failure.

METHODS: Through a review of all patients treated with SRS for BMs at a single institution from January 2005 to December 2014, a total of 34 patients with metastatic breast cancer were identified. Patient, lesion, and treatment-related characteristics and radiologic responses were pooled. The Kaplan-Meier method was used to calculate local control, distant cranial control, and overall survival (OS). A Cox regression model was used to associate prognostic factors with treatment outcomes.

RESULTS: Thirty-four patients received SRS to 124 lesions. Local control and distant cranial control rates at 12 months were 66.6% and 68.1%, respectively. On univariate analysis, lesion size and SRS dose did not have a significant impact on local control. Human epidermal growth factor receptor 2 (HER2) positivity was associated with worse local control, with a hazard ratio (HR) of 2.5 (P = .04). OS rates at 12 months and 24 months were 66.3% and 43%, respectively. HER2 positivity was associated with a trend of improved survival (HR, 0.5; P = .1). Among 17 patients who survived more than 12 months, 10 developed distant BMs at a median of 16 months and received further SRS to 43 lesions. Nine patients maintained Karnofsky performance status over 80, and median OS after the second course of SRS was 21 months. No neurologic toxicity ≥ grade 3 was observed in this cohort.

CONCLUSIONS: SRS is effective in treating BMs from breast cancer, and multiple courses of SRS are feasible and safe in select patients. Since this population can have a prolonged survival, aggressive local treatment with SRS can lead to improved survival and prevention of neurologic deficits.

Proceedings of the 98th Annual Meeting of the American Radium Society -americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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