Cancer Research and Treatment

Original Articles

Breast cancer

Dural Metastasis in Breast Cancer: MRI-Based Morphological Subtypes and Their Clinical Implications: Sung Jun Ahn, Bio Joo, Mina Park, Hun Ho Park, Sang Hyun Suh, Sung Gwe Ahn, Jihwan Yoo; Cancer Res Treat. 2024;56(4):1105-1112. Published online March 19, 2024; DOI: https://doi.org/10.4143/crt.2024.138

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Purpose
This study aimed to investigate the clinical factors associated with breast cancer (BRCA) dural metastases (DMs), their impact on prognosis compared to brain parenchymal metastases (BPMs) alone, and differences between DM subtypes, aiming to inform clinical decisions.
Materials and Methods
We retrospectively analyzed 119 patients with BRCA with brain metastasis, including 91 patients with BPM alone and 28 patients with DM. Univariate and multivariate analyses were performed to compare the clinical characteristics between the two groups and within subtypes of DM. Overall survival after DM (OSDM) and the interval from DM to leptomeningeal carcinomatosis (LMC) were compared using Kaplan-Meier analysis.
Results
DM was notably linked with extracranial metastasis, luminal-like BRCA subtype (p=0.033), and skull metastases (p < 0.001). Multiple logistic regression revealed a strong association of DM with extracranial and skull metastases, but not with subtype or hormone receptor status. Patients with DM did not show survival differences compared with patients with BPM alone. In the subgroup analysis, nodular-type DM correlated with human epidermal growth factor receptor 2 status (p=0.044), whereas diffuse-type DM was significantly associated with a higher prevalence of the luminal-like subtype (p=0.048) and the presence of skull metastasis (p=0.002). Patients with diffuse DM did not exhibit a significant difference in OSDM but had a notably shorter interval from DM to LMC compared to those with nodular DM (p=0.049).
Conclusion
While the impact of DM on the overall prognosis of patients with BRCA is minimal, our findings underscore distinct characteristics and prognostic outcomes within DM subgroups.

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Small-cell neuroendocrine carcinoma of the cervix with leptomeningeal spread: A rare coincidence report and literature review
Mohammed A. Azab, Oday Atallah, Nour El-Gohary, Ahmed Hazim, Hamed Abdelma’aboud Mostafa
Surgical Neurology International.2024; 15: 310. CrossRef
Left homonymous hemianopia as an atypical manifestation of isolated pachymeningeal metastasis secondary to breast cancer: Case report and review of the literature
Aziz Ahizoune, Moad Belouad, Houda Alloussi, Mohamed Allaoui, Mohamed Hamid, Ahmed Bourazza
Radiology Case Reports.2024; 19(11): 5459. CrossRef

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Lung and Thoracic cancer

Real World Characteristics and Clinical Outcomes of HER2-Mutant Non–Small Cell Lung Cancer Patients Detected by Next-Generation Sequencing: Beung-Chul Ahn, Ye-Jeong Han, Hye Ryun Kim, Min Hee Hong, Byoung Chul Cho, Sun Min Lim; Cancer Res Treat. 2023;55(2):488-497. Published online November 9, 2022; DOI: https://doi.org/10.4143/crt.2022.359

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Purpose
This study was conducted to investigate the clinical characteristics of patients with advanced non–small cell lung cancer (NSCLC) harboring human epidermal growth factor receptor 2 (HER2) mutations and to evaluate response to standard treatment and HER2-targeted agents.
Materials and Methods
Using tissue and/or blood next-generation sequencing, we identified 44 patients with NSCLC harboring HER2 mutations who were treated at Severance Hospital between December 2016 and February 2021. Clinical data, including patient characteristics, mutation status, incidence of metastasis for distant lesions, and response to chemotherapy, were retrospectively analyzed.
Results
The median age was 58 years, and 61% of the patients were female. Most patients (64%) were never-smokers. Adenocarcinoma was the most predominant subtype (98%). A total of 66% of the patients had extrathoracic metastatic lesions, and 32% had intracranial lesions at initial presentation. The median time to the development of brain metastasis was 15.6 months (range, 2.4 to 43.7). The most common type of HER2 mutation was 12 base pair in-frame insertion in exon 20, A775_G776insYVMA. Of the 44 patients, two had concomitant driver mutations, one with epidermal growth factor receptor (EGFR) mutation (V769M), and one with BRAF mutation (V600E). Patients treated with pemetrexed-based chemotherapy (75%) had an overall response rate (ORR) and progression-free survival (PFS) of 30% and 8.3 months (95% confidence interval [CI], 3.9 to 12.7), respectively. The ORR and PFS of HER2-targeted agent treated patients (14%) were 0.0% and 1.9 months (95% CI, 0.1 to 2.8), respectively.
Conclusion
Given its distinct characteristics and treatment responses, novel treatment strategies for HER2-mutant NSCLC should be developed promptly to improve survival outcomes of patients.

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Targeted therapy for older patients with an oncogene driven non-small cell lung cancer: Recommendations from a SIOG expert group
L. Decoster, D.R. Camidge, J.A. Fletcher, A. Addeo, A. Greystoke, K. Kantilal, L.Bigay Game, R. Kanesvaran, F. Gomes
Lung Cancer.2025; 200: 108087. CrossRef
HER2-Selective Tyrosine Kinase Inhibitor, Zongertinib (BI 1810631), in Patients With Advanced/Metastatic Solid Tumors With HER2 Alterations: A Phase Ia Dose-Escalation Study
John V. Heymach, Frans Opdam, Minal Barve, Hai-Yan Tu, Yi-Long Wu, David Berz, Lukas Schröter, Yanick Botilde, Behbood Sadrolhefazi, Josep Serra, Kiyotaka Yoh, Noboru Yamamoto
Journal of Clinical Oncology.2025;[Epub] CrossRef
Prognostic factors in non-metastatic HER2 ‘low’ and HER2 ‘negative’ breast cancer: single institute experience
Alper Türkel, Mutlu Doğan, Elif Sertesen, Cengiz Karaçin, Sultan Çiğdem Irkkan, Öztürk Ateş
Wiener klinische Wochenschrift.2024; 136(11-12): 340. CrossRef
Clinicopathologic and Molecular Characteristics of HER2 (ERBB2)-Altered Non–Small Cell Lung Cancer: Implications for Precision Medicine
Yurimi Lee, Boram Lee, Yoon-La Choi, Dong-Wook Kang, Joungho Han
Modern Pathology.2024; 37(6): 100490. CrossRef
Current status and breakthroughs in treating advanced non-small cell lung cancer with EGFR exon 20 insertion mutations
Meng Hu, Congying Zhong, Jiabing Wang, JinQin Chen, Tao Zhou
Frontiers in Immunology.2024;[Epub] CrossRef
Efficacy of chemotherapy plus immune checkpoint inhibitors in patients with non-small cell lung cancer who have rare oncogenic driver mutations: a retrospective analysis
Teppei Yamaguchi, Junichi Shimizu, Reiko Matsuzawa, Naohiro Watanabe, Yoshitsugu Horio, Yutaka Fujiwara
BMC Cancer.2024;[Epub] CrossRef
Antibody–Drug Conjugates for the Treatment of Non-Small Cell Lung Cancer with Central Nervous System Metastases
David J. H. Bian, Sara F. Cohen, Anna-Maria Lazaratos, Nathaniel Bouganim, Matthew Dankner
Current Oncology.2024; 31(10): 6314. CrossRef
Real-World Clinical Outcomes for Patients with EGFR and HER2 Exon 20 Insertion-Mutated Non-Small-Cell Lung Cancer
Kelly Li, Ian Bosdet, Stephen Yip, Cheryl Ho, Janessa Laskin, Barbara Melosky, Ying Wang, Sophie Sun
Current Oncology.2023; 30(8): 7099. CrossRef

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Breast cancer

The Pattern of Care for Brain Metastasis from Breast Cancer over the Past 10 Years in Korea: A Multicenter Retrospective Study (KROG 16-12): Jae Sik Kim, Kyubo Kim, Wonguen Jung, Kyung Hwan Shin, Seock-Ah Im, Hee-Jun Kim, Yong Bae Kim, Jee Suk Chang, Jee Hyun Kim, Doo Ho Choi, Yeon Hee Park, Dae Yong Kim, Tae Hyun Kim, Byung Ock Choi, Sea-Won Lee, Suzy Kim, Jeanny Kwon, Ki Mun Kang, Woong-Ki Chung, Kyung Su Kim, Ji Ho Nam, Won Sup Yoon, Jin Hee Kim, Jihye Cha, Yoon Kyeong Oh, In Ah Kim; Cancer Res Treat. 2022;54(4):1121-1129. Published online December 31, 2021; DOI: https://doi.org/10.4143/crt.2021.1083

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Purpose
We aimed to investigate manifestations and patterns of care for patients with brain metastasis (BM) from breast cancer (BC) and compared their overall survival (OS) from 2005 through 2014 in Korea.
Materials and Methods
We retrospectively reviewed 600 BC patients with BM diagnosed between 2005 and 2014. The median follow-up duration was 12.5 months. We categorized the patients into three groups according to the year when BM was initially diagnosed (group I [2005-2008], 98 patients; group II [2009-2011], 200 patients; and group III [2012-2014], 302 patients).
Results
Over time, the median age at BM diagnosis increased by 2.2 years (group I, 49.0 years; group II, 48.3 years; and group III, 51.2 years; p=0.008). The percentage of patients with extracranial metastasis was 73.5%, 83.5%, and 86.4% for group I, II, and III, respectively (p=0.011). The time interval between BC and BM was prolonged in patients with stage III primary BC (median, 2.4 to 3 years; p=0.029). As an initial brain-directed treatment, whole-brain radiotherapy alone decreased from 80.0% in 2005 to 41.1% in 2014. Meanwhile, stereotactic radiosurgery or fractionated stereotactic radiotherapy alone increased from 13.3% to 34.7% during the same period (p=0.005). The median OS for group I, II, and III was 15.6, 17.9, and 15.0 months, respectively, with no statistical significance.
Conclusion
The manifestations of BM from BC and the pattern of care have changed from 2005 to 2014 in Korea. However, the OS has remained relatively unchanged over the 10 years.

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Comparison of initial and sequential salvage brain-directed treatment in patients with 1–4 vs. 5–10 brain metastases from breast cancer (KROG 16–12)
Jae Sik Kim, Kyubo Kim, Wonguen Jung, Kyung Hwan Shin, Seock-Ah Im, Hee-Jun Kim, Yong Bae Kim, Jee Suk Chang, Jee Hyun Kim, Doo Ho Choi, Yeon Hee Park, Dae Yong Kim, Tae Hyun Kim, Byung Ock Choi, Sea-Won Lee, Suzy Kim, Jeanny Kwon, Ki Mun Kang, Woong-Ki C
Breast Cancer Research and Treatment.2023; 200(1): 37. CrossRef

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Lung and Thoracic cancer

Long-term Survival in Non–Small Cell Lung Cancer Patients with Metachronous Brain-Only Oligorecurrence Who Underwent Definitive Treatment: Hongsik Kim, Sehhoon Park, Hyun Ae Jung, Jong-Mu Sun, Se-Hoon Lee, Jin Seok Ahn, Keunchil Park, Myung-Ju Ahn; Cancer Res Treat. 2022;54(1):150-156. Published online May 6, 2021; DOI: https://doi.org/10.4143/crt.2021.306

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Purpose
Metachronous brain-only oligorecurrence in patients with non–small cell lung cancer (NSCLC) is a rare event with favorable prognosis, but the clinical outcome has not been fully determined. We retrospectively analyzed clinical outcomes and prognostic factors in metachronous brain-only oligorecurrence in patients with NSCLC who underwent definitive treatment.
Materials and Methods
We reviewed 4,437 NSCLC patients without oncogenic driver mutations who underwent definitive treatment between 2008 and 2018. Among them, we identified 327 patients who developed 1 to 5 brain metastases with or without systemic metastasis. Of the 327 patients, 71 had metachronous brain-only oligorecurrence without extracranial progression and were treated with local therapy to the brain. Overall survival (OS), progression-free survival (PFS), and prognostic factors affecting OS were analyzed.
Results
The median OS was 38.9 months (95% confidence interval [CI], 21.8 to 56.1 months) in 71 patients. The 2-year OS rate was 67.8% and the 5-year OS rate was 33.1%. The median PFS was 25.5 months (95% CI, 12.2 to 14.4 months). The longest surviving patient had a survival period of 115 months. Through multivariate analysis, Eastern Cooperative Oncology Group ≥ 1 (hazard ratio, 5.33; p=0.005) was associated with poor survival. There was no significant difference in OS between patients with local therapy and those with local plus systemic therapy (18.5 months vs. 34.7 months, p=0.815).
Conclusion
Metachronous brain-only oligorecurrence NSCLC patients who underwent definitive treatment experienced long-term survival with local therapy, highlighting the unique patient population. The role of systemic chemotherapy in this patient population requires further investigation.

Citations

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Brain Metastasis of Non-small Cell Lung Cancer After Disease-Free Survival of 5 years: Case Series and Comprehensive Literature Review
Takahiro Suzuki, Shoichi Deguchi, Keigo Matsushima, Shinya Katsumata, Hideaki Kojima, Maeda Koki, Hayato Konno, Mitsuhiro Isaka, Takuma Oishi, Yasuhisa Ohde, Takashi Sugino, Koichi Mitsuya, Nakamasa Hayashi
World Neurosurgery.2024; 186: e353. CrossRef
Complex situations in lung cancer: multifocal disease, oligoprogression and oligorecurrence
Raphael Werner, Nina Steinmann, Herbert Decaluwe, Hiroshi Date, Dirk De Ruysscher, Isabelle Opitz
European Respiratory Review.2024; 33(172): 230200. CrossRef

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Breast cancer

Real-World Data of Pyrotinib-Based Therapy in Metastatic HER2-Positive Breast Cancer: Promising Efficacy in Lapatinib-Treated Patients and in Brain Metastasis: Ying Lin, Mingxi Lin, Jian Zhang, Biyun Wang, Zhonghua Tao, Yiqun Du, Sheng Zhang, Jun Cao, Leiping Wang, Xichun Hu; Cancer Res Treat. 2020;52(4):1059-1066. Published online April 24, 2020; DOI: https://doi.org/10.4143/crt.2019.633

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Purpose
Pyrotinib is a newly-developed irreversible pan-ErbB receptor tyrosine kinase inhibitor. This study reported the first real-world data of pyrotinib-based therapy in metastatic human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC), focusing on efficacy in lapatinib-treated patients and in brain metastasis.
Materials and Methods
One hundred thirteen patients with metastatic HER2-positive BC treated with pyrotinib-based therapy in Fudan University Shanghai Cancer Center under non-clinical trial settings from September 1, 2018 to March 1, 2019 were included.
Results
Over half patients have received more than two lines of systematic therapy and exposed to two or more kinds of anti-HER2 agents. Most patients received a combined therapy, commonly of pyrotinib plus capecitabine, or vinorelbine or trastuzumab. Median progression-free survival (PFS) was 6.3 months (range, 5.54 to 7.06 months) and objective response rate (ORR) was 29.5%, with two patients (1.9%) achieving complete response. Lapatinib-naïve patients had significantly longer PFS than lapatinib-treated patients (9.0 months vs. 5.4 months, p=0.001). ORR for lapatinib-treated patients was 23.2%. Thirty-one of 113 patients have brain metastasis. Median PFS was 6.7 months and intracranial ORR was 28%. For patients without concurrent radiotherapy and/or brain surgery, the ORR was very low (6.3%). But for patients receiving concurrent radiotherapy and/or brain surgery, the ORR was 66.7%, and three patients achieved complete response. Most common adverse event was diarrhea.
Conclusion
Pyrotinib-based therapy demonstrated promising effects in metastatic HER2-positive BC and showed activity in lapatinib-treated patients. For patients with brain metastasis, pyrotinib-based regimen without radiotherapy showed limited efficacy, but when combined with radiotherapy it showed promising intracranial control.

Citations

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Comparison of the prognostic effect of pyrotinib plus trastuzumab and chemotherapy different lines therapy in HER2-positive advanced breast cancer
Yangqingqing Zhou, Hui Wang, Jiao Yang, Fan Wang, Danfeng Dong, Xiaoai Zhao, Le Wang, Ruiyuan He, Zhiping Ruan, Jin Yang
Journal of Chemotherapy.2025; 37(2): 135. CrossRef
Pyrotinib-assisted whole brain radiotherapy alleviates HER2-positive advanced breast cancer and brain metastases: a prospective study in patients
Fulin Zhou, Cui Zhang, Mingyuan He, Yu Ren, Hongshuang Yue, Zhihua Tan, Shaolin Zhang, Yong Li, Shu Liu
Frontiers in Neurology.2025;[Epub] CrossRef
Neurotoxicity-sparing radiotherapy for brain metastases in breast cancer: a narrative review
Dagmara Buczek, Renata Zaucha, Jacek Jassem
Frontiers in Oncology.2024;[Epub] CrossRef
HER2-positive metastatic breast cancer with brain metastases responds favorably to pyrotinib and trastuzumab-based treatment: A case report and literature review
Min-long Chen, Wenjie Yu, Binbin Cui, Yijian Yu, Zhaosheng Ma
Frontiers in Oncology.2023;[Epub] CrossRef
Efficacy and safety of inetetamab-containing regimens in patients with HER2-positive metastatic breast cancer: a real-world retrospective study in China
Xiaoyu Liu, Peng Zhang, Chao Li, Xiang Song, Zhaoyun Liu, Wenna Shao, Sumei Li, Xinzhao Wang, Zhiyong Yu
Frontiers in Oncology.2023;[Epub] CrossRef
Evolving management of HER2+ breast cancer brain metastases and leptomeningeal disease
Matthew N. Mills, Whitney King, Aixa Soyano, Yolanda Pina, Brian J. Czerniecki, Peter A. Forsyth, Hatem Soliman, Hyo S. Han, Kamran A. Ahmed
Journal of Neuro-Oncology.2022; 157(2): 249. CrossRef
Temporal Heterogeneity of HER2 Expression and Spatial Heterogeneity of 18F-FDG Uptake Predicts Treatment Outcome of Pyrotinib in Patients with HER2-Positive Metastatic Breast Cancer
Chengcheng Gong, Cheng Liu, Zhonghua Tao, Jian Zhang, Leiping Wang, Jun Cao, Yannan Zhao, Yizhao Xie, Xichun Hu, Zhongyi Yang, Biyun Wang
Cancers.2022; 14(16): 3973. CrossRef
Cost-Effectiveness of Pyrotinib Plus Capecitabine versus Lapatinib Plus Capecitabine for the Treatment of HER2-Positive Metastatic Breast Cancer in China: A Scenario Analysis of Health Insurance Coverage
Yuwen Bao, Zhuolin Zhang, Xuan He, Lele Cai, Xiao Wang, Xin Li
Current Oncology.2022; 29(9): 6053. CrossRef
An Insight into Molecular Targets of Breast Cancer Brain Metastasis
Mohammed Kaleem, Mahmood Hassan Dalhat, Lubna Azmi, Turky Omar Asar, Wasim Ahmad, Maimonah Alghanmi, Amal Almostadi, Torki A. Zughaibi, Shams Tabrez
International Journal of Molecular Sciences.2022; 23(19): 11687. CrossRef
Real-World Outcome and Prognostic Factors Among HER2-Positive Metastatic Breast Cancer Patients Receiving Pyrotinib-Based Therapy: A Multicenter Retrospective Analysis
Jing Liu, Xianglu Sun, Qianyu Du, Jinghao Yao, Mengfen Dai, Qianqian Cheng, Han Xu, Yawei Li, Xiuli Liu, Mingliang Zhang, Yongchun Zhou, Yan Yang
Breast Cancer: Targets and Therapy.2022; Volume 14: 491. CrossRef
Eribulin Efficacy on Brain Metastases in Heavily Pretreated Patients with Metastatic Breast Cancer
Renaud Sabatier, Johan Martin, Cécile Vicier, Mathilde Guérin, Audrey Monneur, Magali Provansal, Louis Tassy, Carole Tarpin, Jean-Marc Extra, Frédéric Viret, Anthony Goncalves
Journal of Clinical Medicine.2021; 10(6): 1272. CrossRef
Pyrotinib Combined With Vinorelbine in HER2-Positive Metastatic Breast Cancer: A Multicenter Retrospective Study
Yi Li, Yixuan Qiu, Huihui Li, Ting Luo, Wei Li, Hong Wang, Bin Shao, Biyun Wang, Rui Ge
Frontiers in Oncology.2021;[Epub] CrossRef
Multiple Administrations of Itraconazole Increase Plasma Exposure to Pyrotinib in Chinese Healthy Adults
Yueyue Liu, Qian Zhang, Chao Lu, Wei Hu
Drug Design, Development and Therapy.2021; Volume 15: 2485. CrossRef
Brain Metastases in HER2-Positive Breast Cancer: Current and Novel Treatment Strategies
Alejandro Garcia-Alvarez, Andri Papakonstantinou, Mafalda Oliveira
Cancers.2021; 13(12): 2927. CrossRef
Pyrotinib Plus Vinorelbine Versus Lapatinib Plus Capecitabine in Patients With Previously Treated HER2-Positive Metastatic Breast Cancer: A Multicenter, Retrospective Study
Yizhao Xie, Yi Li, Luo Ting, Die Sang, Peng Yuan, Wei Li, Huihui Li, Rui Ge, Biyun Wang
Frontiers in Oncology.2021;[Epub] CrossRef
The Efficacy of Pyrotinib as a Third- or Higher-Line Treatment in HER2-Positive Metastatic Breast Cancer Patients Exposed to Lapatinib Compared to Lapatinib-Naive Patients: A Real-World Study
D. J Ouyang, Q. T Chen, M. Anwar, N. Xie, Q. C. Ouyang, P. Z. Fan, L. Y. Qian, G. N. Chen, E. X. Zhou, L. Guo, X. W. Gu, B. N. Ding, X. H. Yang, L. P. Liu, C. Deng, Z. Xiao, J. Li, Y. Q. Wang, S. Zeng, Shouman Wang, Wenjun Yi
Frontiers in Pharmacology.2021;[Epub] CrossRef
Updates on Molecular Targeted Therapies for Intraparenchymal CNS Metastases
Akanksha Sharma, Lauren Singer, Priya Kumthekar
Cancers.2021; 14(1): 17. CrossRef

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Radiation-induced Necrosis Deteriorating Neurological Symptoms and Mimicking Progression of Brain Metastasis after Stereotactic-guided Radiotherapy: Young Zoon Kim, Dae Yong Kim, Heon Yoo, Hee Seok Yang, Sang Hoon Shin, Eun Kyung Hong, Kwan Ho Cho, Seung Hoon Lee; Cancer Res Treat. 2007;39(1):16-21. Published online March 31, 2007; DOI: https://doi.org/10.4143/crt.2007.39.1.16

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Purpose

Although radiation-induced necrosis (RIN) is not a tumor in itself, the lesion progressively enlarges with mass effects and diffuse peritumoral edema in a way that resembles neoplasm. To identify the RIN that mimics progression of brain metastasis, we performed surgical resections of symptomatic RIN lesions.

Meterials and Methods

From June 2003 to December 2005, 7 patients received stereotactic-guided radiotherapy (SRT) for metastatic brain tumor, and they later underwent craniotomy and tumor resection due to the progressive mass effects and the peritumoral edema that caused focal neurological deficit. On MR imaging, a ring-like enhanced single lesion with massive peritumoral edema could not be distinguished from progression of brain metastasis.

Results

Four patients had non-small cell lung cancer, 2 patients had colorectal cancer and 1 patient had renal cell carcinoma. The mean tumor volume was 8.7 ml (range: 3.0~20.7 ml). The prescribed dose of SRT was 30 Gy with 4 fractions for one patient, 18 Gy for two patients and 20 Gy for the other four patients. The four patients who received SRT with a dose of 20 Gy had RIN with or without microscopic residual tumor cells.

Conclusions

Early detection of recurrent disease after radiotherapy and identifying radiation-induced tissue damage are important for delivering adequate treatment. Therefore, specific diagnostic tools that can distinguish RIN from progression of metastatic brain tumor need to be developed.

Citations

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Local radiation enhances systemic CAR T-cell efficacy by augmenting antigen crosspresentation and T-cell infiltration
Nektarios Kostopoulos, Francesca Costabile, Elisavet Krimitza, Silvia Beghi, Denisa Goia, Renzo Perales-Linares, George Thyfronitis, Michael J. LaRiviere, Elise A. Chong, Stephen J. Schuster, Amit Maity, Constantinos Koumenis, John P. Plastaras, Andrea Fa
Blood Advances.2024; 8(24): 6308. CrossRef
Salvage craniotomy for treatment-refractory symptomatic cerebral radiation necrosis
Ashish H Shah, Anil K Mahavadi, Alexis Morell, Daniel G Eichberg, Evan Luther, Christopher A Sarkiss, Alexa Semonche, Michael E Ivan, Ricardo J Komotar
Neuro-Oncology Practice.2020; 7(1): 94. CrossRef
OAR sparing 3D radiotherapy planning supported by fMRI brain mapping investigations
Gábor Opposits, Csaba Aranyi, Csaba Glavák, Zsolt Cselik, Lajos Trón, Dávid Sipos, Janaki Hadjiev, Ervin Berényi, Imre Repa, Miklós Emri, Árpád Kovács
Medical Dosimetry.2020; 45(4): e1. CrossRef
The Role of Navigated Transcranial Magnetic Stimulation Motor Mapping in Adjuvant Radiotherapy Planning in Patients With Supratentorial Brain Metastases
Maximilian J. Schwendner, Nico Sollmann, Christian D. Diehl, Markus Oechsner, Bernhard Meyer, Sandro M. Krieg, Stephanie E. Combs
Frontiers in Oncology.2018;[Epub] CrossRef
Impact of the radiosurgery prescription dose on the local control of small (2 cm or smaller) brain metastases
Alireza M. Mohammadi, Jason L. Schroeder, Lilyana Angelov, Samuel T. Chao, Erin S. Murphy, Jennifer S. Yu, Gennady Neyman, Xuefei Jia, John H. Suh, Gene H. Barnett, Michael A. Vogelbaum
Journal of Neurosurgery.2017; 126(3): 735. CrossRef
Nonthermal ablation in the rat brain using focused ultrasound and an ultrasound contrast agent: long-term effects
Nathan McDannold, Yongzhi Zhang, Natalia Vykhodtseva
Journal of Neurosurgery.2016; 125(6): 1539. CrossRef
Analysis of risk and predictors of brain radiation necrosis after radiosurgery
Hongqing Zhuang, Yi Zheng, Junjie Wang, Joe Y. Chang, Xiaoguang Wang, Zhiyong Yuan, Ping Wang
Oncotarget.2016; 7(7): 7773. CrossRef
Discriminating radiation necrosis from tumor progression in gliomas: a systematic review what is the best imaging modality?
Ashish H. Shah, Brian Snelling, Amade Bregy, Payal R. Patel, Danoushka Tememe, Rita Bhatia, Evelyn Sklar, Ricardo J. Komotar
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Comparison of Swallowing Functions Between Brain Tumor and Stroke Patients
Dae Hwan Park, Min Ho Chun, Sook Joung Lee, Yoon Bum Song
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Treatment Outcome of Brain Metastasis after the Cranial Radiotherapy Followed by Fractionated Stereotactic Radiotherapy and Its Prognostic Factors: Hak Jae Kim, Semie Hong, Suzy Kim, Jin Ho Kim, Il Han Kim, Charn Il Park, Sung Whan Ha, Hong Gyun Wu, Wee Saing Kang; Cancer Res Treat. 2002;34(4):284-288. Published online August 31, 2002; DOI: https://doi.org/10.4143/crt.2002.34.4.284

Abstract PDF

To evaluate the effectiveness of whole brain radiotherapy followed by stereotactic radiotherapy for newly diagnosed brain metastasis.
MATERIALS AND METHODS
Thirty-three metastatic brain tumors received radiotherapy to the whole brain and stereotactic radiotherapy in 25 patients. Lung carcinomas were the most common (17/25) primary tumor. The radiation dose was 30 to 40 Gy for the whole brain, with a 12 to 40 Gy boost to the metastatic foci. Survival and local control rates were determined, and the prognostic factors for survival were evaluated.
RESULTS
The overall median survival was 15 months and the actuarial survivals at 1- and 2-year were 67% and 31%, respectively. The local tumor control rate was 79%, with a median follow-up period of 9 months (2~36 months). The prognostic factors associated with survival were age, tumor size and the existence of active extracranial metastasis, with the performance status showing marginal significance. No acute or chronic complications were observed in the patients.
CONCLUSION
From our data, cranial radiotherapy followed by stereotactic radiotherapy was useful in the local control of metastatic tumors, and in the survival of patients with tumor factors, such as small size or the absence of extracranial tumor activity, and host factors, such as young age or good performance status.

Citations

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Prognostic Factors and Survival Outcome of Whole Brain Radiotherapy in Metastatic Brain Cancer- A Single Regional Cancer Centre Experience in North India
Purnima Thakur, Aman Sharma, Manish Gupta, Anupama Dhiman, Jyoti Sharma
Journal of Evolution of Medical and Dental Sciences.2019; 8(43): 3206. CrossRef
Clinical outcome of central nervous system metastases from breast cancer: differences in survival depending on systemic treatment
Hee-Jun Kim, Seock-Ah Im, Bhumsuk Keam, Yu-Jung Kim, Sae-Won Han, Tae Min Kim, Do-Youn Oh, Jee Hyun Kim, Se-Hoon Lee, Eui Kyu Chie, Wonshik Han, Dong-Wan Kim, Tae-You Kim, Dong-Young Noh, Dae Seog Heo, In Ae Park, Yung-Jue Bang, Sung Whan Ha
Journal of Neuro-Oncology.2012; 106(2): 303. CrossRef

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Clinical Features and Prognosis of Lung Cancer with Brain Metastasis: Kyung Eun Lee, Eun Mi Nam, He Jin Lee, Seung Hyun Nam, Do Yeun Kim, Seock Ah Im, Chu Myung Seong, Soon Nam Lee, Kyung Ja Lee; Cancer Res Treat. 2001;33(3):250-255. Published online June 30, 2001; DOI: https://doi.org/10.4143/crt.2001.33.3.250

Abstract PDF

PURPOSE
Brain metastasis is estimated to occur in 20~40% of solid tumor patients and the most common primary tumor is lung cancer. Even though the prognosis of brain metastasis is grave and the 1-year survival rate is only 15%, symptom palliations are made with whole brain radiation therapy. We retrospectively evaluated the clinical features and prognostic factors of lung cancer with brain metastasis.
MATERIALS AND METHODS
From January 1987 to October 1999, 50 lung cancer patients with brain metastasis underwent whole brain radiation therapy. We reviewed the improvement in neurologic symptoms and survival according to the following parameters; performance status, histological type, presence of brain metastasis at the initial diagnosis of lung cancer, presence of extracranial metastasis, multiplicity of brain lesion, presence of primary lung symptom and treatment modalities.
RESULTS
The most frequent symptom with brain metastasis was a headache (50%). Palliation of the headache and other symptoms was achieved in 81% of the patients. Median overall survival after brain metastasis was 21 weeks and the 1 year survival rate was 15%. Patients without extracranial metastasis had a longer median survival than those with, 38 weeks versus 15 weeks, respectively (p=0.01).
CONCLUSION
In lung cancer with brain metastasis, neurologic symptoms can be palliated with whole brain radiation therapy, and in this study among such patients, absence of extracranial metastasis can be a good prognostic factor.

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Combination of EGFR-Directed Tyrosine Kinase Inhibitors (EGFR-TKI) with Radiotherapy in Brain Metastases from Non-Small Cell Lung Cancer: A 2010–2019 Retrospective Cohort Study
Vineeth Tatineni, Patrick J. O’Shea, Shreya Saxena, Atulya A. Khosla, Ahmad Ozair, Rupesh R. Kotecha, Xuefei Jia, Yasmeen Rauf, Erin S. Murphy, Samuel T. Chao, John H. Suh, David M. Peereboom, Manmeet S. Ahluwalia
Cancers.2023; 15(11): 3015. CrossRef

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Brain Metastasis and Leptomeningeal Carcinomatosis in Breast Cancer: Yoon Soo Chang, Jeong Hun Seo, Ruth Lee, Joong Bae Ahn, Kwang Yong Shim, Soo Jung Gong, Hwa Young Lee, Sun Young Rha, Nae Choon Yoo, Chang Ok Suh, Joo Hang Kim, Jae Kyung Rho, Kyong Sik Lee, Jin Sik Min, Byung Soo Kim, Hyun Cheol Chung; J Korean Cancer Assoc. 1998;30(3):464-474.

Abstract PDF: PURPOSE
Brain metastasis is estimated to occur in 20 to 40% of cancer patients, and meningeal involvement has been reported in 5% to 8% of cancer patients. Even if the prognosis is grave, standard treatment modality of brain metastasis or leptomeningeal carcinomatosis has not been established. We evaluated the prognosis and the clinical features of the brain and leptomeningeal metastasis of the breast cancer.
MATERIALS AND METHODS
The 43 patients who was diagnosed as brain parenchymal metastasis or leptomeningeal carcinomatosis clinically, radiologically and/or cytologically were included in this study. The median age was 44(range: 27-61) years.
RESULTS
The median duration from brain metastasis to death was 181 days(range: 8~1599), and the median duration from leptomeningeal carcinomatosis to death was 39 days(range: 25~152). Age(p=0.7174) and number of brain metastatic lesion(p=0.4097) did not influence the survival, but the presence of other systemic metastatic lesion affected the survival(p 0.0224). When we compared the survival rates of patients according to treatment modality, the patients with systemic chemotherapy versus patients without systemic chemotherapy showed differences(p= 0.0009). Patients treated with whole brain radiation only versus patients with whole brain radiation and other systemic management also showed different survival rate(p=0.0009). But intrathecal chemotherapy had no effect on survival. Well differentiated, solitary lesions were treated by operation and/or gamma-knife surgery, and their effects were good.
CONCLUSION
Prolongation of survival was suggested with whole brain radiotherapy combined with systemic treatment in brain or leptomeningeal metastasis. Further study is expected to confirm this finding.

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A Case of Hemorrhagic Brain Matastasis from Hepatocellular Carcinoma Manifesting Bitemporal Hemianopsia: Ho Yeol Choi, Heon Soo Kim, Tae Rim Park, Joong San Suh, Jae Myung Lee, Young Suk Park, Keun Chil Park, Duk Jhe Shun, Ho Chul Kim, Chul Sun Choi, Gu Kang; J Korean Cancer Assoc. 1994;26(6):973-980.

Abstract PDF: Brain metastasis from primary hepatocellular carcinoma(HCC) is very rare. The authors describe a case of hemorrhagic brain metastasis from hepatocellular carcinoma manifesting bitemporal hemianopsia. The patient was a 56-year old male, who had been diagnosed as HCC with metastasis to the lung in February, 1994. Since then he had been given palliative chemo- therapy with cisplatin and adriamycin with very good response. In June, 1994, he had experience sudden decrease of visual acuity and headache. Neruologic examination revealed anisocoria and bitemporal hemianopsia, and brain MRI demonstrated mutiple hemorrhagic metastases to both occipital lobes and high right parietal lobe. The diagnosis was confirmed by the liver biopsy. This is the first case in Korea, to the best of our knowledge, of HCC with hemorrhagic brain metastasis, manifesting bitemporal hemianopsia.

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