Postoperatif radyoterapi alan ve almayan meme kanseri hastalarında beyin nüks paterni

Abstract

Amaç ve Hedefler: Postoperatif radyoterapi (RT), meme kanseri (MK) hastalarında hastalığın tekrarlama örüntüsünü değiştirir; daha az hastada lokorejyonel nüks ve uzak metastaz görülür. Ancak, postoperatif RT'nin beyin metastazı (BM) örüntüleri üzerindeki etkisi belirsizdir. Yöntemler: Ocak 2007 ile Aralık 2023 tarihleri ​​arasında hastanemizde meme kanseri beyin metastazı (MKBM) tanısı alan hastaların klinik kayıtlarını inceledik. Küratif meme cerrahisi sonrası postoperatif RT'nin beyin metastazına kadar geçen süre (TTBM) ve beyin nüks örüntüsü üzerindeki etkisini gösterdik. Bulgular: Çalışmaya toplam 252 hasta dahil edildi, bunlardan 220'si postoperatif RT aldı ve 32'si almadı. Ortanca TTBM 50,4 ay, BM sonrası ortanca sağkalım ise 9,2 ay olarak bulundu. RT grubundaki hastaların %24,1'inde izole BM gelişirken, RT uygulanmayan gruptaki hastaların hiçbirinde önce beyin metastazı gelişmedi (p<0,001). RT grubunda, ilk nüks yeri BM gelişen hastalar için ortanca TTBM 25,9 ay (95% Cl, 20,9-30,8) iken, vücudun diğer bölgelerinde ilk nüks gelişen hastalar için 57,7 ay (95% Cl, 46,2-69,2) olarak bulundu (p<0,001). RT grubunda ortanca TTBM 45,5 ay iken, RT yapılmayan grupta 92,6 ay olarak bulundu (çok değişkenli ayarlanmış analiz; p=0,088). Ameliyat sonrası RT, tanı anından ekstra BM'lere kadar geçen süreyi etkilemedi (p=0,728). Sonuç: Çalışmamız, postoperatif RT'nin izole beyin metastazlarında nispeten daha yüksek bir tekrarlama paternini ortaya çıkarabileceğini ancak TTBM'yi etkilemediğini düşündürmektedir.

Keywords

• Meme kanseri
• postoperatif radyoterapi
• izole beyin metastazı
• beyin metastazına kadar geçen süre

Brain recurrence patterns in breast cancer patients with or without postoperative radiotherapy

Abstract

Aims: Postoperative radiotherapy (RT) has been shown to reduce locoregional and distant recurrence in breast cancer (BC). Nevertheless, its specific influence on the development and patterns of brain metastasis (BM) is not well established. Methods: We retrospectively reviewed the medical records of patients diagnosed with BC brain metastasis (BCBM) at our institution between January 2007 and December 2023 to assess the impact of RT following curative breast surgery on time to brain metastasis (TTBM) and patterns of brain recurrence. Results: A total of 252 patients were included, of whom 220 received postoperative RT and 32 did not. The median TTBM was 50.4 months, and the median survival after BM was 9.2 months. While 24.1% of patients in the RT group developed isolated BMs, no patients in the non-RT group developed BM first (p<0.001). In the RT group, the median TTBM was 25.9 months (95% Cl, 20.9-30.8) for the patients who developed BMs as the first recurrence site and 57.7 months (95% Cl, 46.2-69.2) for those who had a first recurrence at other sites in the body (p<0.001). The overall median TTBM was 45.5 months in the RT group and 92.6 months in the non-RT group (multivariate adjusted analysis; p=0.088). Postoperative RT did not affect the time from diagnosis to extracranial metastases (p=0.728). Conclusion: Our study suggested that postoperative RT may reveal a relatively higher recurrence pattern of isolated brain metastases but does not affect TTBM.

Keywords

• Breast cancer
• postoperative radiotherapy
• isolated brain metastasis
• time to brain metastasis

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