Brain Metastases in Patients with Metastatic Breast Cancer : Prognosis According to Subtype

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  • サブタイプ別にみた乳癌転移性脳腫瘍の予後
  • 臨床経験 サブタイプ別にみた乳癌転移性脳腫瘍の予後
  • リンショウ ケイケン サブタイプ ベツ ニ ミタ ニュウガン テンイセイ ノウ シュヨウ ノ ヨゴ

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The incidence of brain metastasis or meningeal dissemination (central nervous system metastasis [CNSMet]) is increasing with the improvement of prognosis after relapse. We examined CNSMet cases in our hospital. Of 237 patients with advanced and recurrent breast cancers treated between November 2003 and December 2016, 33 (13.2%) developed CNSMet. The median overall survival (mOS) after relapse in all the cases was 5.11 years. The mOS of the patients with CNSMet was significantly shorter (p < 0.01) than that of the patients without CNSMet (2.2 and 5.35 yr, respectively). Of the HR+/Her2+ (LH group), HR/Her2+ (H group), HR+/Her2 (L group), and HR/Her2 (TN group), 2(8.7%) of 23, 9(36%) of 25, 12(8.5%) of 142, and 10 (21.3%) of 47 patients developed CNSMet, respectively. Of the patients, 9 received only palliative care, 14 underwent brain tumor resection (surgery alone in 5 and combination with radiotherapy in 9), and 10 received radio therapy alone. After topical treatment, 9 patients received anti-Her 2 drug ± chemotherapy ; 7, chemotherapy ; and 3, endocrine therapy. The median time from initial recurrence to CNSMet was 483 days. All cases with onset within 1 year were assigned in the H or TN group. The mOS after CNSMet was 535 days in the Her2 + group, which was longer than the 83 days in the TN group. Screening for CNSMet after first recurrence and treatment choice according to subtype should be taken into consideration

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