249P - Focalized treatment strategy for patients with 1 to 5 breast cancer brain metastasis: a retrospective study of 70 patients treated with surgery or...

Date 10 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Surgical Oncology
Breast Cancer
Therapy
Radiation Oncology
Presenter Lauriane Eberst
Citation Annals of Oncology (2016) 27 (6): 68-99. 10.1093/annonc/mdw365
Authors L. Eberst1, M. Morelle1, M. Sunyach2, E. Jouanneau3, P. Heudel1, O. Tredan1, R. Tanguy2, I.L. Ray-Coquard1, T. Bachelot1
  • 1Medecine, Centre Léon Bérard, 69373 - Lyon/FR
  • 2Radiotherapy, Centre Léon Bérard, 69373 - Lyon/FR
  • 3Neurosurgery, Hôpital Louis Pradel-Hospices Civils de Lyon, Bron/FR

Abstract

Background

Systemic treatment for metastatic breast cancer (MBC) has improved, allowing better control of extracranial disease, and longer survival. As a consequence, incidence of brain metastasis (BM) increases. Focalized treatment with surgical excision or stereotactic radiosurgery (SRS) should be considered for patients with a low number of BM.

Methods

We identified all MBC patients undergoing focalized treatment by surgery or SRS, for 1 to 5 BM in our institution, between January 2008 and January 2015, with the aim of describing their outcome.

Results

70 patients were identified: 39 treated with surgery for 1 to 2 BM, 29 treated with SRS for 1 to 5 BM, and 2 patients treated with both modalities for 2 to 3 BM. After a median follow-up of 49 months, 55% of patients (38 among 69) had brain recurrence. From focalized treatment of BM, recurrence-free survival (RFS) was 20 months for the whole cohort (n = 69, [11-26]). From BM diagnosis, median OS was 37 months (n = 70, 95%CI[20-52]) for the whole cohort, with significant differences according to tumor subtypes (p = 0.008, log-rank test, see table below). In multivariate analysis, HR positivity (HR à 0,39 [0,16-0,93], p = 0.033), and extracranial disease control (HR à 0,15 [0,06-0,39], p 

Conclusions

Patients with a low number of BM from MBC who had aggressive treatment with surgery or SRS have a favorable outcome. WBRT use should be delayed as much as possible, to avoid neurocognitive sequelae.

Clinical trial identification

Not applicable

Legal entity responsible for the study

Centre Leon Berard

Funding

Centre Leon Berard

Disclosure

All authors have declared no conflicts of interest.