BACKGROUND The purpose of our study was to characterize clinical features among brain metastasis (BM) patients who were long term survivors (LTS). METHODS We reviewed a registry of BM patients referred to our multidisciplinary BM clinic between 2006 and 2014 and identified 97 who lived ≥ 3 years following BM diagnosis. The clinical and treatment characteristics were obtained from a prospectively maintained database, and additional information was obtained through review of electronic medical records and radiologic images. Survival analyses were performed using the Kaplan-Meier method. RESULTS Median follow up for LTS was 67 months (range 36-181). Median age was 54 years, 65% had single BM, 39% had stable extracranial disease at the time of BM treatment, and brain was the first site of metastasis in 76%. Targetable mutations were present in 39% of patients and 66% received treatment with targeted-, hormonal-, or immuno-therapy. Brain surgery at the time of diagnosis was performed in 40% and stereotactic radiosurgery (SRS) or whole brain radiotherapy (alone or combination) in 52% and 56%, respectively. Following initial BM treatment, 5-year intracranial disease-free survival was 39%, and the cumulative incidence of symptomatic radio-necrosis was 16%. Five and ten-year overall survival was 72% and 26%, respectively. CONCLUSION Most LTS were younger than 60 years old and had a single BM. Many received treatment with surgery or targeted, immune, or hormonal therapy.

中文翻译：

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长期存活脑转移患者的临床病理和治疗特征

背景我们研究的目的是表征长期幸存者（LTS）脑转移（BM）患者的临床特征。方法 我们回顾了 2006 年至 2014 年期间转诊到我们的多学科 BM 诊所的 BM 患者的注册，并确定了 97 名在 BM 诊断后存活 ≥ 3 年的患者。临床和治疗特征是从一个前瞻性维护的数据库中获得的，另外的信息是通过查看电子病历和放射影像获得的。使用 Kaplan-Meier 方法进行生存分析。结果 LTS 的中位随访时间为 67 个月（范围 36-181）。中位年龄为 54 岁，65% 有单一 BM，39% 在 BM 治疗时有稳定的颅外疾病，76% 的患者脑是第一个转移部位。39% 的患者存在可靶向突变，66% 的患者接受了靶向治疗、激素治疗或免疫治疗。诊断时的脑部手术占 40%，立体定向放射外科 (SRS) 或全脑放疗（单独或联合）分别占 52% 和 56%。在初始 BM 治疗后，5 年颅内无病生存率为 39%，症状性放射坏死的累积发生率为 16%。五年和十年总生存率分别为 72% 和 26%。结论 大多数 LTS 年龄小于 60 岁并且只有一个 BM。许多人接受了手术或靶向、免疫或激素治疗。诊断时的脑部手术占 40%，立体定向放射外科 (SRS) 或全脑放疗（单独或联合）分别占 52% 和 56%。在初始 BM 治疗后，5 年颅内无病生存率为 39%，症状性放射坏死的累积发生率为 16%。五年和十年总生存率分别为 72% 和 26%。结论 大多数 LTS 年龄小于 60 岁并且只有一个 BM。许多人接受了手术或靶向、免疫或激素治疗。诊断时的脑部手术占 40%，立体定向放射外科 (SRS) 或全脑放疗（单独或联合）分别占 52% 和 56%。在初始 BM 治疗后，5 年颅内无病生存率为 39%，症状性放射坏死的累积发生率为 16%。五年和十年总生存率分别为 72% 和 26%。结论 大多数 LTS 年龄小于 60 岁并且只有一个 BM。许多人接受了手术或靶向、免疫或激素治疗。结论 大多数 LTS 年龄小于 60 岁并且只有一个 BM。许多人接受了手术或靶向、免疫或激素治疗。结论 大多数 LTS 年龄小于 60 岁并且只有一个 BM。许多人接受了手术或靶向、免疫或激素治疗。