Whole brain radiotherapy for brain metastases from breast cancer: estimation of survival using two stratification systems
Results
The overall survival rate in 1, 2 and 3 years was 33.4 %, 16.7%, and 8.8 %, respectively (figure-1). The interval between the diagnoses of breast cancer and brain metastasis was 32 months (range 0 – 74). The RPA class analysis showed strong relation with survival (p < 0.0001), table- 2.
The median survival time by RPA class in months was: class I 11.7, class II 6.2 and class III 3.0 as showed in table- 3.
According to BS-BM system, the median survival was of 24.6 months for patients with a score of 3, 6.6 months for patients with a score of 2, 4.7 months for patients with a score of 1, and 2.8 months for patients with a score of 0 (p < 0.0001), as demonstrated in table-3. Three patients were alive in moment of this analysis with a median survival time of 4.42 years (range, 3.8 – 5.1). All these patients had single brain metastasis, high KPS, cranial extra disease controlled, submitted to surgical resection before WBRT, had RPA class 1 and BS-BM 3. The significant prognostic factors on univariate analysis associated with better survival were: higher KPS (p < 0.0001), surgical resection (P < 0.0001), single metastases (p = 0.003), controlled primary tumor (p = 0.002) and absence of extracranial metastases (p = 0.001), as showed in table-2 and figures 2, 3, 4, 5, 6. In multivariate analysis, the factors associated positively with survival were: surgical resection (p < 0.0001), absence of extracranial metastases (p <0.0001) and RPA class I (p < 0.0001), as demonstrated in table-4.
