Symptomatic RT was observed in 16 patients. Asymptomatic RT typical imaging changes without clinical signs was observed in nine patients. One patient developed an asymptomatic intratumoral hemorrhage after SRS. The presence of multiple brain metastases from breast carcinoma portends rapid clinical deterioration. Most patients with these metastases undergo palliative WBRT. However, unsatisfactory overall survival results and relatively high brain failure rates have been reported by various investigators.
It can be used in conjunction with, or as an alternative to, other treatment methods and can be performed on an outpatient basis. Due to a limited number of reported treatment results after SRS for brain metastases of patients with breast carcinoma, the therapeutic impact on this patient subpopulation remains unclear. Our objective was to assess the specific therapeutic impact of a local treatment concept SRS on patients with brain metastases from breast carcinoma.
Only 9 of patients did not respond to local treatment. Radiosurgical retreatment was performed for all patients with local or new distant metastases to the brain and a stable systemic tumor status. The overall MST was 10 months. For example, an overall survival of 4—5 months was reported after conventional WBRT. Longer survival durations have been reported following surgery and WBRT. One could argue that the true impact of SRS is overshadowed by the effects of systemic chemotherapy which has been reported to yield favorable responses in selected patients with breast carcinoma applied to most patients in the current study.
However, the interaction of systemic chemotherapy and radiosurgery was not further analyzed in the current study. The current analysis refers to a selected subpopulation with small and primarily multiple brain metastases from breast carcinoma. Radiosurgical treatment planning and execution were comparable for all patients.
SRS was planned and exclusively performed for all patients by a single neurosurgery specialist. The remarkable finding was that the presence of multiple metastases had no prognostic impact for this selected patient population. This finding does not support the results of several recent surgical, radiosurgical, and radiotherapeutic trials.
It is noteworthy that the WBRT, which is regarded as the standard treatment for patients with multiple brain metastases, did not have a prognostic impact on 46 patients who received additional WBRT. There was no difference in local tumor control or survival time. Most notably, patients undergoing multiple radiosurgical procedures for local or distant retreatment did not have a higher risk of developing radiogenic complications compared with patients undergoing a single session.
In summary, outpatient stereotactic radiosurgery is a feasible treatment method for controlling small brain metastases from breast carcinoma. Outcome is particularly favorable in patients with a controlled primary tumor and no extracranial disease RPA Class I. The number of brain metastases has no prognostic relevance. Volume , Issue 8. If you do not receive an email within 10 minutes, your email address may not be registered, and you may need to create a new Wiley Online Library account.
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Original Article Free Access. Alexander Muacevic M. Corresponding Author E-mail address: amuacevi helios. Friedrich W. Kreth M. Berndt Wowra M. Tools Request permission Export citation Add to favorites Track citation. Share Give access Share full text access. Share full text access. Please review our Terms and Conditions of Use and check box below to share full-text version of article. Characteristic No.
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Adult CNS Radiation Oncology. Principles and Practice
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