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Patterns of Treatment and Outcome in Patients With 20 or More Brain Metastases
Carsten Nieder1,2, Rosalba Yobuta3, Bård Mannsåker3
1Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway carsten.nieder@nlsh.no.
Background/Aim:
The aim of this study was to analyze the patterns of treatment and outcomes in patients with a large number of brain metastases, arbitrarily defined as 20 or more lesions. These patients are typically excluded from studies of focal brain treatment, e.g., surgery or radiosurgery, and might have a limited prognosis.
Patients And Methods:
This was a retrospective single-institution analysis. Overall, 11 patients were identified from a prospectively maintained database.
Results:
Ten patients had received active treatment (9 whole-brain radiotherapy, 7 systemic therapy). Median survival was 5.0 months without long-term survival beyond 13 months. Patients with better performance status had numerically longer survival, however we did not identify baseline parameters with a significant impact on survival.
Conclusion:
While long-term survival was not observed in this small study, most patients survived long enough to experience symptomatic improvement from whole-brain radiotherapy. Therefore, we recommend multidisciplinary assessment of the patients' prognosis and systemic treatment options, and initiation of whole-brain radiotherapy if survival is not limited to 1-2 months.
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