International Journal of Radiation Oncology * Biology * Physics
Volume 69, Issue 3 , Pages 839-845 , 1 November 2007

Brain Metastases From Breast Carcinoma: Validation of the Radiation Therapy Oncology Group Recursive Partitioning Analysis Classification and Proposition of a New Prognostic Score

  • Romuald Le Scodan, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • Corresponding Author InformationReprint requests to: Romuald Le Scodan, M.D., Department of Radiation Oncology, Centre René Huguenin, 35 rue Dailly, 92210 Saint Cloud, France. Tel: (+33) 1-47-11-23-59; Fax: (+33) 1-47-11-15-87
    • ,
  • Christophe Massard, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Emmanuelle Mouret-Fourme, M.D.

      Affiliations

    • Department of Medical Statistics, Centre René Huguenin, Saint Cloud, France
    • ,
  • Jean Marc Guinebretierre, M.D., Ph.D.

      Affiliations

    • Department of Pathology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Christine Cohen-Solal, M.D.

      Affiliations

    • Corresponding Author InformationReprint requests to: Romuald Le Scodan, M.D., Department of Radiation Oncology, Centre René Huguenin, 35 rue Dailly, 92210 Saint Cloud, France. Tel: (+33) 1-47-11-23-59; Fax: (+33) 1-47-11-15-87
    • ,
  • Brigitte De Lalande, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Patricia Moisson, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Christelle Breton-Callu, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Miriam Gardner, M.D., Ph.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Alain Goupil, M.D.

      Affiliations

    • Department of Medical Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Nicole Renody, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Jean Louis Floiras, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France
    • ,
  • Alain Labib, M.D.

      Affiliations

    • Department of Radiation Oncology, Centre René Huguenin, Saint Cloud, France

Received 24 January 2007 ,Revised 12 April 2007 ,Accepted 13 April 2007.

References 

  1. Gabos Z, Sinha R, Hanson J, et al. Prognostic significance of human epidermal growth factor receptor positivity for the development of brain metastasis after newly diagnosed breast cancer. J Clin Oncol. 2006;24:5658–5663
  2. Miller KD, Weathers T, Haney LG, et al. Occult central nervous system involvement in patients with metastatic breast cancer: Prevalence, predictive factors and impact on overall survival. Ann Oncol. 2003;14:1072–1077
  3. Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys. 1997;37:745–751
  4. Slimane K, Andre F, Delaloge S, et al. Risk factors for brain relapse in patients with metastatic breast cancer. Ann Oncol. 2004;15:1640–1644
  5. Clayton AJ, Danson S, Jolly S, et al. Incidence of cerebral metastases in patients treated with trastuzumab for metastatic breast cancer. Br J Cancer. 2004;91:639–643
  6. Bendell JC, Domchek SM, Burstein HJ, et al. Central nervous system metastases in women who receive trastuzumab-based therapy for metastatic breast carcinoma. Cancer. 2003;97:2972–2977
  7. Lin NU, Bellon JR, Winer EP. CNS metastases in breast cancer. J Clin Oncol. 2004;22:3608–3617
  8. Fokstuen T, Wilking N, Rutqvist LE, et al. Radiation therapy in the management of brain metastases from breast cancer. Breast Cancer Res Treat. 2000;62:211–216
  9. Mintz AH, Kestle J, Rathbone MP, et al. A randomized trial to assess the efficacy of surgery in addition to radiotherapy in patients with a single cerebral metastasis. Cancer. 1996;78:1470–1476
  10. Lentzsch S, Reichardt P, Weber F, et al. Brain metastases in breast cancer: Prognostic factors and management. Eur J Cancer. 1999;35:580–585
  11. Khuntia D, Brown P, Li J, et al. Whole-brain radiotherapy in the management of brain metastasis. J Clin Oncol. 2006;24:1295–1304
  12. Sundstrom JT, Minn H, Lertola KK, et al. Prognosis of patients treated for intracranial metastases with whole-brain irradiation. Ann Med. 1998;30:296–299
  13. Murray KJ, Scott C, Greenberg HM, et al. A randomized phase III study of accelerated hyperfractionation versus standard in patients with unresected brain metastases: A report of the Radiation Therapy Oncology Group (RTOG) 9104. Int J Radiat Oncol Biol Phys. 1997;39:571–574
  14. Mehta MP, Rodrigus P, Terhaard CH, et al. Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases. J Clin Oncol. 2003;21:2529–2536
  15. Claude L, Perol D, Ray-Coquard I, et al. Lymphopenia: A new independent prognostic factor for survival in patients treated with whole brain radiotherapy for brain metastases from breast carcinoma. Radiother Oncol. 2005;76:334–339
  16. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481
  17. Cox DR. Regression models and life-tables. J R Stat Soc B. 1972;34:187–202
  18. Engel J, Eckel R, Aydemir U, et al. Determinants and prognoses of locoregional and distant progression in breast cancer. Int J Radiat Oncol Biol Phys. 2003;55:1186–1195
  19. Chang J, Clark GM, Allred DC, et al. Survival of patients with metastatic breast carcinoma: Importance of prognostic markers of the primary tumor. Cancer. 2003;97:545–553
  20. Lederman G, Wronski M, Fine M. Fractionated radiosurgery for brain metastases in 43 patients with breast carcinoma. Breast Cancer Res Treat. 2001;65:145–154
  21. Mahmoud-Ahmed AS, Suh JH, Lee SY, et al. Results of whole brain radiotherapy in patients with brain metastases from breast cancer: A retrospective study. Int J Radiat Oncol Biol Phys. 2002;54:810–817
  22. Ray-Coquard I, Van Glabbeke M, Negrier S. Lymphopenia as an independent prognostic factor for survival in advanced carcinoma, soft tissue carcinoma and lymphoma. [Abstract] Proc Am Soc Clin Oncol. 2000;19:2591
  23. Samaan NA, Buzdar AU, Aldinger KA, et al. Estrogen receptor: A prognostic factor in breast cancer. Cancer. 1981;47:554–560
  24. Stewart JF, King RJ, Sexton SA, et al. Oestrogen receptors, sites of metastatic disease and survival in recurrent breast cancer. Eur J Cancer. 1981;17:449–453
  25. Wronski M, Arbit E, McCormick B. Surgical treatment of 70 patients with brain metastases from breast carcinoma. Cancer. 1997;80:1746–1754
  26. Sneed P, Melisko M, Moore D, et al. Predicting survival in breast cancer patients with brain metastases. [Abstract] Proc Am Soc Clin Oncol. 2003;22:168
  27. Li J, Bentzen SM, Renschler M, et al. Regression after whole-brain radiation therapy for brain metastases correlates with survival and improved neurocognitive function. J Clin Oncol. 2007;25:1260–1266

 Presented in part at the 42nd Annual Meeting of the American Society of Clinical Oncology, June 2–6, 2006, Atlanta, GA.

 Conflict of interest: none.

PII: S0360-3016(07)00695-5

doi: 10.1016/j.ijrobp.2007.04.024

International Journal of Radiation Oncology * Biology * Physics
Volume 69, Issue 3 , Pages 839-845 , 1 November 2007

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