Prognostic factors affecting the outcome of brain metastases from breast cancer.
OBJECTIVE
The purpose of this study is to analyze the overall survival rate of patients with brain metastases from breast cancer and to determine prognostic factors affecting outcomes of these patients.


METHODS
From July 1988 to December 2004, 48 female patients with brain metastases from breast cancer underwent full-dose whole-brain radiotherapy (WBRT). In these patients we evaluated the significance of the following factors in predicting the survival rate after WBRT: age, extracranial metastases, number of brain metastases, total dose of WBRT, Karnofsky performance status (KPS), and Radiation Therapy Oncology Group recursive partitioning analysis (RPA) class.


RESULTS
The median overall survival rate was 7.3 months. The 1- and 2-year overall survival rates were 37 and 20%, respectively. In univariate analysis, KPS (p<0.0001), number of lesions of brain metastases (p=0.0149), age (p=0.0452), and RPA class (p<0.0001) were statistically significant prognostic factors for overall survival. In multivariate analysis, KPS (p<0.001) and number of brain metastases (p=0.039) were significant prognostic factors for overall survival.


CONCLUSIONS
Survival of breast cancer patients with brain metastases treated with WBRT is poor. To improve survival, enrollment of more patients with brain metastases from breast cancer for prospective trials involving a multimodality approach that combines radiation and systemic therapies based on appropriate patient triage is warranted.
Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan, Republic of China. 40217@cch.org.tw
Mu-Tai
MT
Liu
Chang-Yao
CY
Hsieh
Ai-Yih
AY
Wang
Tung-Hao
TH
Chang
Chu-Pin
CP
Pi
Chia-Chun
CC
Huang
Chao-Yuan
CY
Huang
Cheng-Hong
CH
Liou
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D016371:Cranial Irradiation; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017567:Karnofsky Performance Status; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome