| Author/Editor | Žnidarič, Tanja; Ratoša, Ivica | |
| Title | Karcinoza možganskih ovojnic in rak dojk | |
| Translated title | Leptomeningeal carcinomatosis and breast cancer | |
| Type | članek | |
| Vol. and No. | Letnik 23, št. 1 | |
| Publication year | 2019 | |
| Volume | str. 18-26 | |
| ISSN | 1408-1741 - Onkologija : strokovni časopis za zdravnike | |
| Language | slv | |
| Abstract | Uvod: Karcinoza možganskih ovojnic (LMK) nastane z zasevanjem tumorskih celic na možganske ovojnice in pomeni slabo prognozo. Obsevanje je ena izmed možnosti zdravljenja za ublažitev nevroloških simptomov. Metode: V retrospektivno analizo smo vključili 423 bolnic z rakom dojke (RD) in možganskimi zasevki (MZ) ali LMK, ki so se v obdobju med 2005 in 2015 z obsevanjem glave zdravile na Onkološkem inštitutu Ljubljana. Podrobneje smo analizirali skupino bolnic z LMK, za katere smo tudi preverili uporabnost dveh prognostičnih lestvic preživetja, Breast Graded Prognostic Assessment (Breast-GPA) in Simple Survival Score for Brain Metastases (SS-BM). Rezultati: Z obsevanjem glave smo v opazovanem obdobju zdravili 70 bolnic z LMK. Srednji čas od diagnoze RD do pojava LMK je znašal 4,3 leta, vendar je bil ta čas najkrajši pri trojno negativnem in najdaljši pri luminal A podtipu RD. Srednje celokupno preživetje je za bolnice z MZ in LMK znašalo 7,5 (95-% interval zaupanja, IZ; 6,3%8,8) in 2,3 meseca (95-% IZ; 1,5%3,2) (p < 0,005) ter se je razlikovalo glede na molekularni podtip RD. Na daljše preživetje ni vplivala višja prejeta doza obsevanja (% 20 Gy vs. > 20 Gy). Z analizo smo potrdili prognostično vrednost lestvice Breast-GPA (p < 0,005) in SS-BM (p = 0,044). Zaključki: Pričakovano preživetje se je v naši skupini analiziranih bolnic z LMK razlikovalo glede na stanje zmogljivosti, molekularni podtip RD ter seštevek točk prognostične lestvice.Introduction: Leptomeningeal carcinomatosis (LMC) develops with infiltration of leptomeninges by malignant cells and means poor prognosis. Radiotherapy presents one of the treatment options for neurological symptom relief. Methods: We retrospectively analyzed 423 patients with breast cancer (BC) and brain metastasis (BM) or LMC, who received radiotherapy of the brain between the years 2005 and 2015 at the Institute of Oncology Ljubljana. We analyzed patients with LMC in more detail and performed a validation of prognostic survival indexes, namely Breast Graded Prognostic Assessment (Breast-GPA) and Simple Survival Score for Brain Metastases (SS-BM). Results: Seventy patients with LMC were treated with whole-brain radiotherapy in the observed time. Median time from BC diagnosis to LMC appearance was 4.3 years and was shortest in triple-negative and longest in luminal A BC subtype. Median overall survival for patients with BM and LMC was 7.5 (95 % confidence interval, CI; 6.3%8.8) and 2.3 months (95 % CI; 1.5%3.2), respectively (p < 0,005), and it varied depending on the molecular BC subtype. Survival was not affected by a higher total dose of radiation received (% 20 Gy vs. > 20 Gy). Breast-GPA (p < 0,005) and SS-BM (p = 0,044) indexes predicted survival with statistical significance. Conclusions: Performance status, BC molecular subtype and prognostic indexes were all factors influencing expected survival in our group of analyzed LMC patients. | |
| Keywords | rak dojke karcinoza možganskih ovojnic obsevanje radioterapija breast cancer leptomeningeal carcinomatosis radiotherapy |