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Three-institution study on applicability of initial brain metastasis velocity for breast cancer brain metastasis patients undergoing stereotactic radiosurgery

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Abstract

Purpose

This study aimed to validate whether the recently-proposed prognostic grading system, initial brain metastasis velocity (iBMV), is applicable to breast cancer patients receiving stereotactic radiosurgery (SRS). We focused particularly on whether this grading system is useful for patients with all molecular types, i.e., positive versus negative for EsR, PgR and HER2.

Methods and materials

This was an institutional review board-approved, retrospective cohort study using our database, prospectively accumulated at three gamma knife institutes, during the 20-year-period since 1998. We excluded patients for whom the day of primary cancer diagnosis was not available, had synchronous presentation, lacked information regarding molecular types, and/or had received pre-SRS radiotherapy and/or surgery. We ultimately studied 511 patients categorized into two classes by iBMV scores, i.e., < 2.00 and ≥ 2.00.

Results

The median iBMV score for the entire cohort was 0.97 (IQR 0.39–2.84). Median survival time (MST) in patients with iBMV < 2.00, 15.9 (95% CI 13.0–18.6, IQR 7.5–35.5) months, was significantly longer than that in patients with iBMV ≥ 2.00, 8.2 (95% CI 6.8–9.9, IQR 3.9–19.4) months (HR 1.582, 95% CI: 1.308–1.915, p < 0.0001). The same results were obtained in patients with EsR (−), PgR (−), HER2 (+) and HER2 (−) cancers, while MSTs did not differ significantly between iBMV < 2.00 vs ≥ 2.00 in patients with EsR (+) and PgR (+) cancers.

Conclusions

This system was clearly shown to be applicable to breast cancer patients with SRS-treated BMs. However, this system is not applicable to patients with hormone receptor (+) breast cancer.

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Funding

The authors have no sources of financial and/or material support to declare.

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Authors and Affiliations

  1. Katsuta Hospital Mito GammaHouse, 5125-2 Nakane, Hitachi-naka, Hitachinaka, Ibaraki, 312-0011, Japan

    Masaaki Yamamoto & Bierta E. Barfod

  2. Department of Neurosurgery, Tokyo Women’s Medical University Medical Center East, 8-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan

    Masaaki Yamamoto & Hidetoshi Kasuya

  3. Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, 1-9-9 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Toru Serizawa

  4. Gamma Knife House, Chiba Cerebral and Cardiovascular Center, 575 Tsurumai, Ichihara, 290-0512, Japan

    Osamu Nagano & Kyoko Aoyagi

  5. Department of Neurological Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8677, Japan

    Osamu Nagano, Kyoko Aoyagi & Yoshinori Higuchi

  6. Department of Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Tokyo, 160-1211, Japan

    Yasunori Sato

Authors
  1. Masaaki Yamamoto
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  2. Toru Serizawa
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  3. Osamu Nagano
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  4. Kyoko Aoyagi
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  5. Yoshinori Higuchi
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  6. Yasunori Sato
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  7. Hidetoshi Kasuya
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  8. Bierta E. Barfod
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Correspondence to Masaaki Yamamoto.

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Yamamoto, M., Serizawa, T., Nagano, O. et al. Three-institution study on applicability of initial brain metastasis velocity for breast cancer brain metastasis patients undergoing stereotactic radiosurgery. J Neurooncol 147, 177–184 (2020). https://doi.org/10.1007/s11060-020-03412-z

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  • DOI: https://doi.org/10.1007/s11060-020-03412-z

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