Radt-14. role of chemotherapy after radiation therapy for gynecologic metastases to the brain
Neuro-oncology(2023)
Abstract
Abstract BACKGROUND Brain metastasis from gynecologic malignancy is rare, and the optimal treatment is undetermined. METHODS Retrospective data was collected at a single institution from 2001-2021 on 66 patients with brain metastasis from gynecologic malignancy who underwent brain radiation therapy (RT). Kaplan-Meier survival analyses, long-rank tests, and a multivariate proportional hazards model were performed. RESULTS Median overall survival (OS) and intracranial progression-free survival (PFS) were 4.3 and 3.6 months, respectively. 25 (38%) patients started chemotherapy after RT in a median 32.5 days (IQR 12-53). Compared to those who did not start chemotherapy after RT, those who did had a longer median OS (9.8 vs 2.6 months, p < 0.01) and PFS (5.0 vs 2.5 months, p = 0.01). On univariate analysis, factors associated with worse survival included >10 brain metastases (p = 0.09), leptomeningeal involvement (p < 0.01), presence of extracranial disease (p = 0.01), no receipt of surgery (p = 0.05), receipt of whole brain RT (p < 0.01), and no receipt of chemotherapy after RT (p < 0.01). On multivariate analysis including above factors and age-adjusted Charlson Comorbidity Index, only receipt of chemotherapy after RT was significantly associated with improved survival (HR 0.32, CI 0.16-0.64). The most common chemotherapy was platinum-based agents in 10 (40%) patients, with no difference in survival (p = 0.74) between those treated with platinum-based versus other agents. More patients who started chemotherapy after RT compared to those who didn’t had ovarian cancer (56 vs 22%, p = 0.02), underwent surgery (52 vs 29%, p = 0.07), and underwent stereotactic radiosurgery (SRS) (64 vs 27%, p < 0.01). For patients who did vs did not receive chemotherapy after SRS, median OS was 11.3 vs 4.3 months (p = 0.01), and after WBRT 4.5 vs 2.2 months (p = 0.10). CONCLUSION Patients treated with chemotherapy after SRS in this population may have improved outcomes, though prognosis remains poor.
MoreTranslated text
Key words
radiation chemotherapy,gynecologic metastases
AI Read Science
Must-Reading Tree
Example
![](https://originalfileserver.aminer.cn/sys/aminer/pubs/mrt_preview.jpeg)
Generate MRT to find the research sequence of this paper
Chat Paper
Summary is being generated by the instructions you defined