Potential prognostic markers for survival and neurologic death in patients with breast cancer brain metastases who receive upfront SRS alone
Rachel F. Shenker, Ryan T. Hughes, Emory R. McTyre, Claire Lanier, Hui-Wen Lo, Linda Metheny-Barlow, Jing Su, Alexandra Thomas, Doris R. Brown, Tiffany Avery, Boris Pasche, Christina K. Cramer, Adrian W. Laxton, Stephen B. Tatter, Kounosuke Watabe and Michael D. Chan
Purpose/Objectives: Stereotactic radiosurgery (SRS) is used as a treatment option for breast cancer brain metastases. It is unclear what factors predict neurologic death for these patients.
Materials/Methods: A total of 128 patients with breast cancer brain metastases were treated with upfront SRS alone in this study. Survival was estimated using the Kaplan-Meier method. Clinicopathologic factors evaluated included age, ER/PR status, Her2 status, numbers of brain metastases treated, minimum SRS dose, disease-specific GPA, extracranial disease status and systemic disease burden.
Results: ER or PR positivity was associated with a trend towards decreased neurologic death (subdistribution hazard ratio (sHR) = 0.54, p=0.06). Factors associated with non-neurologic death include extracranial disease status (sHR = 2.02, p=0.02) and dose (sHR = 1.11, p=0.02); Her2- positivity was associated with reduced hazard of non-neurologic death (sHR 0.52, p=0.05).
Conclusions: ER/PR positivity was associated with a trend towards less neurologic death. HER2 positivity was associated with a trend towards less non-neurologic death.
Keywords: breast cancer, brain metastases, neurologic death, prognostic factors, breast cancer metastases
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