Breast Radiotherapy: A Potential Risk Factor for Resistant Clone Development in Patients with Brain Metastasis
Received Date : 06 Dec 2023
Accepted Date : 23 Nov 2024
Available Online : 11 Dec 2024
Hasan Çağrı YILDIRIMa, Gözde KAVGACIa, Yasemin EVLENDİa, Elvin CHALABIYEVa, Deniz Can GÜVENa, Ömer DİZDARa
, Melis GÜLTEKİNb, Ferah YILDIZb, Sercan AKSOYa
aHacettepe University Faculty of Medicine, Division of Medical Oncology, Ankara, Türkiye
bHacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, Türkiye
Doi: 10.37047/jos.2023-100649 - Article's Language: EN
J Oncol Sci.
ABSTRACT
Objective: The human brain is a frequent site of breast cancer metastasis. The various therapeutic approaches for treating brain
metastases include surgical intervention, stereotactic radiosurgery (SRS), and whole-brain radiotherapy (WBRT). However, the literature on the
association between prior breast RT and the effectiveness of intracranial RT subsequent to treatment is scarce. The present study, therefore, aimed
to understand the association between previous breast RT and intracranial progression-free survival (iPFS). Material and Methods: In the present
study, the relationship of epidemiological, pathological, and clinical features, especially previous breast RT, with iPFS was explored in the
patients diagnosed with HER2-positive breast cancer along with brain metastasis. These patients did not undergo surgery for brain metastasis and
received WBRT/SRS instead. Results: Fifty-one patients were included in the present study. The median age of these patients was 46 years.
Among the included patients, 20 patients had previously undergone whole breast or chest wall RT. In 19 patients, SRS was utilized rather than
WBRT. The iPFS was significantly shorter in patients who had previously received RT for the primary lesion compared to those who had not received
RT (mPFS: 7.96 vs. 14.56 months, p=0.002, HR: 3.06, CI: 1.52-6.12). No relationships of iPFS with the treatments used prior to RT, type
of RT, sites of metastasis during RT, systemic therapy administered after RT, and status of de novo metastatic/recurrent disease were noted. Conclusion:
Patients who had undergone previous RT to the locoregional region exhibited significantly poorer iPFS following the RT performed for
brain metastasis.
Keywords: Breast radiotherapy; HER-2 positive breast cancer; brain metastasis