Population-based outcomes after brain radiotherapy in patients with brain metastases from breast cancer in the Pre-Trastuzumab and Trastuzumab eras

Radiation Oncology

Scott Tyldesley¹  Hagen Kennecke³  Caroline Speers²  Ryan Woods²  Alan Nichol¹  Sarah Hamilton¹  Irene Karam¹ 

[1] Radiation Therapy Program, BC Cancer Agency – Vancouver Centre, 600 west 10th Avenue, Vancouver, BC, V5Z 4E6, Canada;Breast Cancer Outcomes Unit, BC Cancer Agency, Vancouver, BC, Canada;Systemic Therapy Program, BC Cancer Agency, Vancouver, BC, Canada

关键词: HER2 status;    Trastuzumab;    Brain irradiation;    Brain metastasis;    Breast cancer;   

Others  :  1154746
DOI  :  10.1186/1748-717X-8-12

 received in 2012-11-09, accepted in 2013-01-04,  发布年份 2013

【 摘 要 】

Purpose

To evaluate the survival of patients with human epidermal growth factor receptor 2 (HER2) positive and negative metastatic breast cancer irradiated for brain metastases before and after the availability of trastuzumab (T).

Materials and methods

Women diagnosed with brain metastasis from breast cancer in two eras between 2000 and 2007 (T-era, n = 441) and 1986 to 1992 (PreT-era, n = 307), treated with whole brain radiotherapy (RT) were identified. In the T-era, HER2 testing was part of routine clinical practice, and in the preT-era 128/307 (42%) cases had HER2 testing performed retrospectively on tissue microarrays. Overall survival (OS) was estimated using the Kaplan-Meier method and comparisons between eras used log-rank tests.

Results

In the preT- and T-era cohorts, the rate of HER2 positivity was 40% (176/441) and 26% (33/128) (p < 0.001). The median time from diagnosis to brain RT was longer in the preT-era (3.3 years versus 2.3 years, p < 0.001). Survival after brain RT was improved in the T-era compared to the preT-era (1-year OS 26% versus 12%, p < 0.001). The 1-year OS rate for HER2 negative patients was 20% in both eras (p = 0.97). Among HER2 positive patients, the 1-year OS in the preT-era was 5% compared to 40% in the T-era (p < 0.001).

Conclusions

Distinct from patients with HER2 negative disease in whom no difference in survival after brain RT was observed over time, patients with HER2 positive brain metastases experienced significantly improved survival subsequent to the availability of trastuzumab.

【 授权许可】

   
2013 Karam et al.; licensee BioMed Central Ltd.

【 图 表 】

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