AI Article Synopsis

  • Whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) are key treatments for brain metastases, with this study focusing on the effectiveness of volumetric modulated arc therapy (VMAT-RS) in breast cancer patients.
  • 18 breast cancer patients with 41 brain metastases were evaluated, revealing that HER2+ patients had significantly longer median survival times, with the cerebellum being the most common location for metastases.
  • The findings indicate that VMAT-RS offers comparable survival rates to other radiosurgery methods, highlighting that patients' baseline conditions and cancer subtypes play a crucial role in influencing outcomes.

Article Abstract

Background: Whole-brain radiation therapy (WBRT) and stereotactic radiosurgery (SRS) are two treatment modalities commonly utilized to treat brain metastases (BMs).

Aim: The purpose of this study is to analyse retrospectively the local control and survival of patients with BMs of breast cancer (BC) treated via radiosurgery using Volumetric Modulated Arc Therapy (VMAT-RS).

Methods: 18 patients with 41 BMs of BC and treated by VMAT-RS were studied. They were classified according to the molecular subtype of BC and the modified breast graded prognostic assessment -GPA- index. Patients presented 1-4 BMs, which were treated with 5 non-coplanar VMAT arcs. The spatial distribution of BMs, the influence of receptor status on the location of the lesions and survival assessed via the Kaplan-Meier model were analyzed.

Results: The median survival time (MST) was 19.7 months. Statistically significant differences were determined in the MST according to the Karnofsky performance status (= 0.02) and the HER2 status (= 0.004), being more prolonged in the HER2+ patients. Finally, our results showed that the cerebellum is the predominant site of breast cancer BMs, and also suggested that HER2+BMs had a predilection for some structures of the posterior circulation, such as the cerebellum, brainstem and occipital lobes (= 0.048).

Conclusions: The VMAT-RS is a technique with an overall survival comparable to other radiosurgery techniques. The baseline situation at the time of treatment, the modified breast-GPA and the molecular subtypes, are factors that significantly influence patient survival.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8963509PMC
http://dx.doi.org/10.25100/cm.v52i3.4567DOI Listing

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