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Abstract

PURPOSE: 

In this retrospective study, we compared the incidence of leptomeningeal carcinomatosis or dural metastasis (LMCDM) in patients who received whole brain radiotherapy (WBRT), partial radiotherapy (PRT), or no radiotherapy (RT) following resection of brain metastases from breast cancer.

MATERIALS AND METHODS: 

Fifty-one patients with breast cancer underwent surgical resection for newly diagnosed brain metastases in two institutions between March 2001 and March 2015. Among these, 34 received postoperative WBRT (n=24) or PRT (n=10) and 17 did not.

RESULTS: 

With a median follow-up of 12.4 months (range, 2.3 to 83.6 months), 22/51 patients developed LMCDM at a median of 8.6 months (range, 4.8 to 51.2 months) after surgery. The 18-months LMCDM-free survival (LMCDM-FS) rates were 77.5%, 30.0%, and 13.6%, in the WBRT, PRT, and no RT groups, respectively (p=0.013). The presence of a tumor adjacent to cerebrospinal fluid flow and no systemic treatment after treatment for brain metastases were also associated with poor LMCDM-FS rate. Multivariate analysis showed that WBRT compared to PRT (p=0.009) and systemic treatment (p < 0.001) were independently associated with reduced incidence of LMCDM.

CONCLUSION: 

WBRT improved LMCDM-FS rate after resection of brain metastases compared to PRT in breast cancer patients.​ 

Author information

Ha B1, Chung SY2, Kim YJ1, Gwak HS3, Chang JH4, Lee SH5, Park IH6, Lee KS6, Lee S6, Kim TH1, Kim DY1, Kang SG4, Suh CO2.​

1Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea.2Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.3Neuro-Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea.4Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.5Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea.6Center for Breast Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea.