Radiosurgery with 20 Gy provides better local contol of 1-3 brain metastases from breast cancer than with lower doses

• Published in: Anticancer research Vol. 35; no. 1; pp. 333 - 336
• Main Authors: Rades, Dirk, Huttenlocher, Stefan, Rudat, Volker, Hornung, Dagmar, Blanck, Oliver, Phuong, Pham Cam, Khoa, Mai Trong, Schild, Steven E, Fischer, Dorothea
• Format: Journal Article
• Language: English
• Published: Greece 01.01.2015
• Subjects: Brain Neoplasms - mortality; Brain Neoplasms - secondary; Brain Neoplasms - surgery; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Female; Humans; Kaplan-Meier Estimate; Middle Aged; Proportional Hazards Models; Radiosurgery; Radiotherapy Dosage; Tumor Burden; distant brain control; local control; overall survival; Breast cancer; brain metastasis; radiation dose; radiosurgery
• ISSN: 0250-7005; 1791-7530

To determine the optimal dose of radiosurgery-alone for patients with 1-3 cerebral metastases from breast cancer. Patients receiving 20 Gy (n=20) were compared to those receiving 16-18.5 Gy (n=10) for local control, distant brain control and overall survival. Seven other variables were also evaluated. Radiosurgery dose achieved significance on univariate (p=0.002; log-rank and Wilcoxon test) and multivariate analysis (p=0.004) of local control. Twelve-month local control rates were 94% after 20 Gy and 48% after 16-18.5 Gy. On univariate analysis of distant brain control, radiosurgery dose was not a significant factor, with 12-month rates of 73% and 60%, respectively. Regarding overall survival, radiosurgery dose was of borderline significance (p=0.059; Wilcoxon test). Twelve-month overall survival rates were 75% and 40%, respectively. On Cox regression analysis, radiosurgery dose exhibited a trend for improving survival (p=0.10). Radiosurgery with 20 Gy resulted in significantly better local control and led to a trend towards improved overall survival compared to treatment with 16-18.5 Gy.