Andjie Jeudy BS, David J. Crompton, Danushka S. Seneviratne, Pooja Advani, Jennifer Peterson, William C. Fox, Sanjeet Grewal, Laura Vallow, Daniel M. Trifiletti
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引用次数: 0
Abstract
Objective
Stereotactic radiosurgery is an established treatment for breast cancer brain metastases. However, there is limited data regarding the clinical outcomes of SRS when delivered with targeted systemic therapies. Our aim was to assess the clinical outcomes and toxicities of patients receiving modern systemic therapy concurrently with SRS in comparison to patients undergoing traditional cytotoxic chemotherapy and SRS.
Methods
Through this IRB-approved retrospective analysis, we collected the clinical outcomes of 43 patients with brain metastases from breast cancer treated with SRS in combination with modern targeted systemic therapies (delivered within 4 weeks of SRS).
Results
A total of 235 brain metastases were treated with single fraction SRS in combination with systemic therapy. Of the 235 tumors, 49 were treated with concurrent cytotoxic systemic therapy, 60 with antibody or endocrine, 41 with immunotherapy combination, 56 were not treated with concurrent systemic therapy, and 56 received other systemic therapy. In comparison to patients receiving concurrent cytotoxic chemotherapy and SRS, those receiving antibody/endocrine therapy with SRS and those receiving no systemic therapy had significantly higher rates of local treatment failure (p=0.005). Patients receiving immunotherapy concurrently with SRS had similar rates of local treatment failure compared to those undergoing cytotoxic chemotherapy (p=0.47). We found no association between the type of systemic therapy delivered with SRS and elsewhere brain failure, or radionecrosis (all p>0.2).
Conclusion
Delivery of no therapy with SRS or the delivery of antibody/endocrine therapy concurrently with SRS were both associated with significantly higher rates of local treatment failure.
期刊介绍:
Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent.
The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.