Table 2.
Survival following whole brain radiotherapy among women with breast cancer and brain metastases, 1999–2012
| Characteristics | Median survival months (range) | Adjusted HRa
(95% CI) |
Adjusted HRb
(95% CI) |
|---|---|---|---|
| At the time of WBRT | |||
| Age (years) | |||
| 30–49 | 4.1 (0.2–86.8) | 1.0 (ref) | 1.0 (ref) |
| 50–69 | 2.6 (0–40.6) | 1.36 (1.01–1.84) | 1.13 (0.83–1.54) |
| 70+ | 2.3 (0.1–32.6) | 1.73 (1.15–2.60) | 1.28 (0.84–1.94) |
| Calendar year | |||
| 1999–2001 | 1.6 (0.17–32.6) | 1.85 (1.20–2.86) | 1.91 (1.23–2.96) |
| 2002–2004 | 4.8 (0.4–86.8) | 1.07 (0.67–1.71) | 1.06 (0.66–1.70) |
| 2005–2007 | 3.0 (0–23.0) | 1.26 (0.85–1.88) | 1.32 (0.88–1.97) |
| 2008–2010 | 3.1 (0.1–41.1) | 1.25 (0.87–1.80) | 1.15 (0.80–1.67) |
| 2011–2012 | 2.8 (0.1–35.4) | 1.0 (ref) | 1.0 (ref) |
| No of brain metastases | |||
| 1–3 (Size 5–55 mm) | 2.5 (0.2–36.2) | 1.04 (0.67–1.64) | 1.08 (0.68–1.72) |
| 4–6 | 2.5 (0.3–11.8) | 1.33 (0.82–2.15) | 1.60 (0.98–2.62) |
| 7–9 | 3.1 (0.6–12.4) | 1.22 (0.63–2.38) | 1.46 (0.74–2.88) |
| Massive | 3.0 (0.1–86.8) | 0.94 (0.67–1.33) | 1.13 (0.80–1.60) |
| Leptomeningeal | 2.5 (0–35.4) | 1.0 (ref) | 1.0 (ref) |
| Time between diagnosis and WBRT | |||
| 0–3 years | 2.1 (0–36.2) | 1.62 (1.17–2.24) | 1.51 (1.09–2.10) |
| 3–6 years | 3.5 (0.2–41.1) | 1.47 (1.04–2.08) | 1.24 (0.88–1.76) |
| >6 years | 3.6 (0.1–86.8) | 1.0 (ref) | 1.0 (ref) |
| WBRT dose | |||
| 4 Gy × 5 | 2.6 (0–86.8) | 1.0 (ref) | 1.0 (ref) |
| 3 Gy × 10 | 4.1 (0.2–32.6) | 0.73 (0.47–1.13) | 0.73 (0.47–1.14) |
| Other metastases | |||
| Only brain | 3.7 (0–86.8) | 1.0 (ref) | 1.0 (ref) |
| Brain + visceralc | 2.8 (0.1–21.6) | 1.16 (0.78–1–71) | 1.11 (0.74–1.67) |
| Brain + non viscerald | 4.1 (0.1–32.6) | 0.96 (0.64–1.43) | 1.04 (0.70–1.56) |
| Brain + multiple | 2.5 (0.13–41.1) | 1.59 (1.11–2.27) | 1.37 (0.96–1.94) |
| WHO performance status score | |||
| 0–1 | 5.5 (0.4–86.8) | 1.0 (ref) | –– |
| 2 | 2.0 (0.1–16.5) | 2.78 (2.01–3.84) | |
| 3–4 | 0.9 (0–5.5) | 5.96 (3.88–9.17) | |
| Family situation | |||
| Married/cohabitation | 2.4 (0.1–32.6) | 1.22 (0.87–1.73) | 1.34 (0.95–1.88) |
| Married/cohabitation w/children | 3.2 (0–86.8) | 1.11 (0.73–1.70) | 1.06 (0.69–1.62) |
| Alone w/children | 8.2 (0.2–41.1) | 0.64 (0.33–1.25) | 0.85 (0.43–1.68) |
| Alone | 3.1 (0.1–40.6) | 1.0 (ref) | 1.0 (ref) |
| Level of care (one week before WBRT) | |||
| Home | 4.1 (0.1–86.8) | 1.0 (ref) | 1.0 (ref) |
| Hospital | 2.0 (0–40.6) | 1.53 (1.16–2.04) | 1.03 (0.75–1.40) |
| Palliative inpatient care | 2.5 (0.3–3.7) | 2.60 (1.24–5.45) | 1.11 (0.51–2.42) |
| At primary breast cancer diagnosis | |||
| Stage | |||
| 1 | 4.0 (0.1–86.8) | 1.0 (ref) | 1.0 (ref) |
| 2 | 2.5 (0–40.6) | 1.21 (0.84–1.73) | 1.18 (0.81–1.70) |
| 3 | 2.6 (0.2–41.1) | 1.40 (0.90–2.18) | 1.52 (0.97–2.37) |
| 4 | 1.6 (0.3–21.6) | 1.62 (0.96–2.76) | 1.38 (0.81–2.37) |
| ER | |||
| ER+ | 3.4 (0–86–8) | 1.0(ref) | 1.0 (ref) |
| ER− | 2.6 (0.2–35.4) | 1.35 (1.03–1.77) | 1.33 (1.01–1.77) |
| HER2 | |||
| HER2+ | 4.2 (0.1–86.8) | 1.0 (ref) | 1.0 (ref) |
| HER2− | 2.5 (0–41.1) | 1.28 (0.94–1.75) | 1.27 (0.92–1.75) |
| Subtype | |||
| Luminal A | 3.5 (0–41.1) | 1.0 (ref) | 1.0 (ref) |
| Luminal B | 3.9 (0.1–86.8) | 0.94 (0.62–1.44) | 0.99 (0.64–1.52) |
| HER2 type | 4.1 (0.2–21.6) | 1.04 (0.68–1.57) | 1.04 (0.68–1.61) |
| Triple negative | 2.0 (0.2–35.4) | 1.87 (1.25–2.80) | 1.87 (1.23–2.84) |
| Palliative treatments before WBRT | |||
| Palliative trastuzumab | |||
| Yes | 5.0 (0.1–86.8) | 1.0 (ref) | 1.0 (ref) |
| No | 2.4 (0–41.1) | 1.40 (1.03–1.90) | 1.37 (1.01–1.86) |
| No of palliative chemotherapy regimens | |||
| 0 | 1.6 (0–40.6) | 1.0 (ref) | 1.0 (ref) |
| 1+ | 3.5 (0.1–86.8) | 0.61 (0.44–0.85) | 0.65 (0.46–0.92) |
Statistically significant results are marked in bold
aadjusted for age at WBRT (in 10-year intervals) and calendar period of WBRT (in 3-year intervals)
badjusted for WHO performance status score, age at WBRT (in-10 year intervals) and calendar period of WBRT (in 3-year intervals)
cLung and/or liver metastases
dSkin, loco-regional, and/or bone metastases