title: Predicting the Risk of New Cerebral Lesions After Stereotactic Radiosurgery (SRS) for Brain Metastases from Breast Cancer.
abstract: OBJECTIVE
  To generate a tool that estimates the probability of developing new cerebral metastases after stereotactic radiosurgery (SRS) in breast cancer patients.
  
  
  METHODS
  SRS dose plus seven characteristics (age, performance score, number of cerebral metastases, maximum diameter of all metastases, location of metastases, extra-cerebral spread and time from breast cancer diagnosis until SRS) were analyzed regarding their ability to predict the probability of new cerebral metastases development following SRS. For those characteristics deemed significant, points of 0 (higher risk of new lesions) or 1 (lower risk) were given. Scores were generated by adding the points of significant characteristics.
  
  
  RESULTS
  Performance score (p=0.013) and maximum diameter of all metastases (p=0.022) were associated with development of subsequent brain metastases. Two groups were created, 0-1 and 2 points. Freedom from new cerebral metastases rates were 27% and 92%, respectively, at 15 months (p=0.003).
  
  
  CONCLUSIONS
  This tool helps select breast cancer with few cerebral metastases receiving SRS who may benefit from additional whole-brain irradiation.
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Liesa
authors.initials: L
authors.lastname: Dziggel
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Dahlke
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Janssen
authors.affiliation: Department of Radiation Oncology, University Medical Center Eppendorf, Hamburg, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Hornung
authors.affiliation: CyberKnife Centre Northern Germany, Güstrow, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Blanck
authors.affiliation: Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Mai Trong
authors.initials: MT
authors.lastname: Khoa
authors.affiliation: Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Schild
authors.affiliation: Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
authors.forename: Dirk
authors.initials: D
authors.lastname: Rades
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology / Q000556:secondary*; D001943:Breast Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies
keywords: Cerebral metastases; breast cancer; freedom from new cerebral metastases; prognostic tool; stereotactic radiosurgery