Impact of systemic disease on CNS disease control after stereotactic radiosurgery to breast cancer brain metastases (The SYBRA Study).

IF 6.5 2区医学 Q1 ONCOLOGY

NPJ Breast Cancer Pub Date : 2024-08-02 DOI:10.1038/s41523-024-00673-z

Alex Schick, Sara Hardy, Myla Strawderman, Dandan Zheng, Michael Cummings, Michael T Milano, Allison Magnuson, Jacqueline Behr, Sarah Sammons, Kenneth Usuki, Nimish Mohile, Ruth O'Regan, Carey K Anders, David Hicks, Ajay Dhakal

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Abstract

The objective of the study is to assess impact of systemic disease (SD) status on overall survival and brain metastasis (BM) control, adopting a novel landmark approach to categorize SD among breast cancer (BC) patients. This single institution retrospective study included BCBM patients who have received stereotactic radiosurgery (SRS) to brain. Separate endpoints [CNS failure-free survival (cFFS), overall survival (OS)] were analyzed from each Landmark (LM): LM1 (3-months), LM2 (6-months). Patients were categorized into early and non-early progression (EP, NEP) groups depending on SD status before LMs. Median survivals from LM were assessed with Kaplan Meier plots, compared with Log-Rank test. EP was associated with worse median cFFS and OS vs NEP in both LM analyses (cFFS- LM1: 3.6 vs. 9.7 months, p = 0.0016; LM2: 2.3 vs. 12.5 months, p < 0.0001; OS- LM1: 3.6 vs. 24.3 months, p < 0.0001; LM2: 5.3 vs. 30.2 months, p < 0.0001). In multivariate analyses, EP was associated with shorter cFFS [LM1: Hazard Ratio (HR) with 95% confidence interval (CI) 3.16, 1.46-6.83, p = 0.0034; LM2: 5.32, 2.33-12.15, p = <0.0001] and shorter OS (LM1: HR with 95% CI 4.28, 1.98-9.12, p = 0.0002; LM2: 7.40, 3.10-17.63, p = <0.0001) vs NEP. Early systemic disease progressions after 1st SRS to brain is associated with worse cFFS and OS in patients with BCBM.

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乳腺癌脑转移立体定向放射手术后全身疾病对中枢神经系统疾病控制的影响（SYBRA 研究）。

本研究的目的是评估全身性疾病（SD）状态对总生存期和脑转移（BM）控制的影响，采用一种新的地标方法对乳腺癌（BC）患者的 SD 进行分类。这项单一机构的回顾性研究包括接受过脑部立体定向放射手术（SRS）的乳腺癌患者。对每个地标（LM）的终点[无中枢神经系统衰竭生存期（cFFS）、总生存期（OS）]进行了分析：LM1（3 个月）、LM2（6 个月）。根据LM前的SD状态，将患者分为早期和非早期进展（EP、NEP）组。LM 存活率中位数用 Kaplan Meier 图评估，并用 Log-Rank 检验进行比较。在两次 LM 分析中，EP 与 NEP 相比，与较差的中位 cFFS 和 OS 相关（cFFS- LM1：3.6 个月 vs. 9.7 个月，p = 0.0016；LM2：2.3 个月 vs. 12.5 个月，p = 0.0016）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.