방사선종양학

본문글자크기
  • [J Breast Cancer.] Central Nervous System Failure in Korean Breast Cancer Patients with HER2-Enriched Subtype: Korean Radiation Oncology Group 16-15 Multicenter Retrospective Study.

    서울의대 / 김규보, 김인아*

  • 출처
    J Breast Cancer.
  • 등재일
    2018 Dec 20
  • 저널이슈번호
    22(1):120-130. doi: 10.4048/jbc.2019.22.e1. eCollection 2019 Mar.
  • 내용

    바로가기  >

    Abstract
    Purpose:
    The purpose of this study was to evaluate the risk of central nervous system (CNS) failure in Korean patients with human epidermal growth factor receptor 2 (HER2)-enriched breast cancer treated with surgery followed by postoperative radiotherapy (RT).

    Methods:
    A total of 749 patients from eight institutions were enrolled in this study. All of them underwent surgery followed by postoperative RT from 2003 to 2011; 246 (32.8%) received neoadjuvant chemotherapy and 649 (81.7%) received adjuvant chemotherapy. Adjuvant trastuzumab was administered to 386 patients (48.6%).

    Results:
    The median follow-up duration was 84 (range, 8-171) months. The 7-year disease-free and overall survival rates were 79.0% and 84.2%, respectively. On multivariate analysis, mastectomy, nodal involvement, and presence of lymphatic invasion were correlated with poor overall survival (p = 0.004, 0.022, and 0.011, respectively), whereas T stage and lymphatic invasion were associated with disease-free survival (p = 0.018 and 0.005, respectively). Regarding CNS failures, 30 brain metastases, 2 leptomeningeal metastases, and 8 brain and leptomeningeal metastases were noted. The 7-year CNS relapse-free survival rates in patients receiving and not receiving trastuzumab were 91.2% and 96.9%, respectively (p = 0.005). On multivariate analysis, the administration of adjuvant trastuzumab was the only prognostic factor in predicting a higher CNS failure rate (hazard ratio, 2.260; 95% confidence interval, 1.076-4.746; p = 0.031).

    Conclusion:
    Adjuvant trastuzumab was associated with higher CNS failure rate in Korean patients with HER2-enriched breast cancer. Close monitoring and reasonable approaches such as CNS penetrating HER2 blockades combined with the current standard therapy could contribute to improving intracranial tumor control and quality of life in patients with CNS metastasis from HER2-enriched breast cancer.

     


    Author information

    Kim K1, Shin KH2, Kim JH2, Choi DH3, Park W3, Kim YB4, Kim HJ4,5, Kim JH6, Park H7, Lee SY8, Kim J1, Oh DH9, Kim IA2.
    1
    Department of Radiation Oncology, Ewha Womans University College of Medicine, Seoul, Korea.
    2
    Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea.
    3
    Department of Radiation Oncology, Sungkyunkwan University School of Medicine, Seoul, Korea.
    4
    Department of Radiation Oncology, Yonsei University College of Medicine, Seoul, Korea.
    5
    Department of Radiation Oncology, Gachon University Gil Medical Center, Incheon, Korea.
    6
    Department of Radiation Oncology, Keimyung University College of Medicine, Daegu, Korea.
    7
    Department of Radiation Oncology, Presbyterian Medical Center, Jeonju, Korea.
    8
    Department of Radiation Oncology, Chonbuk National University Hospital, Jeonju, Korea.
    9
    Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Korea.

  • 키워드
    Breast neoplasms; Central nervous system neoplasms; ERBB2 protein; Radiotherapy; Trastuzumab
  • 덧글달기
    덧글달기
       IP : 3.238.198.167

    등록