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KMID : 0939920170490030748
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대한암학회지
2017 Volume.49 No. 3 p.748 ~ p.758
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Effects of Postoperative Radiotherapy on Leptomeningeal Carcinomatosis or Dural Metastasis after Resection of Brain Metastases in Breast Cancer Patients
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Ha Bo-Ram
Chung Seung-Yeun
Kim Yeon-Joo
Gwak Ho-Shin
Chang Jong-Hee
Lee Sang-Hyun
Park In-Hae
Lee Keun-Seok
Lee See-Youn
Kim Tae-Hyun
Kim Dae-Yong
Kang Seok-Gu
Suh Chang-Ok
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Abstract
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Purpose: In this retrospective study, we compared the incidence of leptomeningeal carcinomatosis or dural metastasis (LMCDM) in patients who received whole brain radiotherapy (WBRT), partial radiotherapy (PRT), or no radiotherapy (RT) following resection of brain metastases from breast cancer.
Materials and Methods: Fifty-one patients with breast cancer underwent surgical resection for newly diagnosed brain metastases in two institutions between March 2001 and March 2015. Among these, 34 received postoperative WBRT (n=24) or PRT (n=10) and 17 did not.
Results: With a median follow-up of 12.4 months (range, 2.3 to 83.6 months), 22/51 patients developed LMCDM at a median of 8.6 months (range, 4.8 to 51.2 months) after surgery. The 18-months LMCDM-free survival (LMCDM-FS) rates were 77.5%, 30.0%, and 13.6%, in the WBRT, PRT, and no RT groups, respectively (p=0.013). The presence of a tumor adjacent to cerebrospinal fluid flow and no systemic treatment after treatment for brain metastases were also associated with poor LMCDM-FS rate. Multivariate analysis showed that WBRT compared to PRT (p=0.009) and systemic treatment (p < 0.001) were independently associated with reduced incidence of LMCDM.
Conclusion: WBRT improved LMCDM-FS rate after resection of brain metastases compared to PRT in breast cancer patients.
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KEYWORD
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Breast neoplasms, Meningeal carcinomatosis, Whole brain radiotherapy, Partial radiotherapy
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