脳転移の予後

脳転移患者の生命予後予測ツールは複数開発されている。

RTOG RPA（脳転移患者の予後）

Prognostic groups for outcome after palliative treatment of brain metastases by recursive partitioning analysis
Class Prognostic factors Median survival (months)
I KPS ≥70 percent 7.1
Age <65 years
Controlled primary site
No extracranial metastases
III KPS <70 2.3
II All others 4.2
KPS: Karnofsky performance status.
Gaspar L, et al. Int J Radiat Oncol Biol Phys 1997; 37:745.

HER-2陽性乳癌の脳転移の予後

Prognosis of patients with brain metastases from HER2-positive breast cancer
Study Time period Number of patients Median survival after CNS recurrence
Tham, et al[1] 1970-1999 21 ~3 months
Bendell, et al[2] 1998-2000 42 13 months
Gori, et al[3] 1999-2005 43 23 months
Stemmler, et al[4] 2000-2004 42 13 months
Eichler, et al[5] 2001-2005 30 17 months
Melisko, et al[6] 1997-2007 35 23 months
Brufsky, et al [7] 2003-2009 377 20.3 months
Trastuzumab approved by the United States Food and Drug Administration (FDA) for treatment of HER2-positive, metastatic breast cancer in 1998.
CNS: central nervous system; HER2: human epidermal growth factor receptor 2.

References:

  1. Tham YL, Sexton K, Kramer R, et al. Primary breast cancer phenotypes associated with propensity for central nervous system metastases. Cancer 2006; 107:696.
  2. 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.
  3. Gori S, Rimondini S, De Angelis V, et al. Central nervous system metastases in HER-2 positive metastatic breast cancer patients treated with trastuzumab: incidence, survival, and risk factors. Oncologist 2007; 12:766.
  4. Stemmler HJ, Kahlert S, Siekiera W, et al. Characteristics of patients with brain metastases receiving trastuzumab for HER2 overexpressing metastatic breast cancer. Breast 2006; 15:219.
  5. Eichler AF, Kuter I, Ryan P, et al. Survival in patients with brain metastases from breast cancer: the importance of HER-2 status. Cancer 2008; 112:2359.
  6. Melisko ME, Moore DH, Sneed PK, et al. Brain metastases in breast cancer: clinical and pathologic characteristics associated with improvements in survival. J Neurooncol 2008; 88:359.
  7. Brufsky AM, Mayer M, Rugo HS, et al. Central nervous system metastases in patients with HER2-positive metastatic breast cancer: incidence, treatment, and survival in patients from registHER. Clin Cancer Res 2011; 17:4834.

トリプルネガティブ乳癌の脳転移の予後

Prognosis of patients with brain metastases from triple-negative breast cancer

Study Time period Number of patients Median survival after CNS recurrence
Dawood et al[1] 1980-2006 42 2.9 months
Lin et al[2] 2000-2006 53 4.9 months
Eichler et al[3] 2001-2005 21 4.0 months
Nam et al[4] 2001-2006 47 3.4 months
CNS: central nervous system.
1. Dawood S, Broglio K, Esteva FJ, et al. Survival among women with triple receptor-negative breast cancer and brain metastases. Ann Oncol 2009; 20:621.
2. Lin NU, Claus E, Sohl J, et al. Sites of distant recurrence and clinical outcomes in patients with metastatic triple-negative breast cancer: high incidence of central nervous system metastases. Cancer 2008; 113:2638.
3. Eichler AF, Kuter I, Ryan P, et al. Survival in patients with brain metastases from breast cancer: the importance of HER-2 status. Cancer 2008; 112:2359.
4. Nam BH, Kim SY, Han HS, et al. Breast cancer subtypes and survival in patients with brain metastases. Breast Cancer Res 2008; 10:R20.

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