open access

Vol 25, No 3 (2020)
Original research articles
Published online: 2020-05-01
Submitted: 2019-11-13
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Long-term survival results after treatment for oligometastatic brain disease

Carsten Nieder, Mandy Hintz, Ilinca Popp, Angelika Bilger, Anca L. Grosu
DOI: 10.1016/j.rpor.2020.03.001
·
Rep Pract Oncol Radiother 2020;25(3):307-311.

open access

Vol 25, No 3 (2020)
Original research articles
Published online: 2020-05-01
Submitted: 2019-11-13

Abstract

Aim

The aim of this study was to characterize the survival results of patients with up to four brain metastases after intense local therapy (primary surgery or stereotactic radiotherapy) if extracranial metastases were absent or limited to one site, e.g. the lungs.

Background

Oligometastatic disease has repeatedly been reported to convey a favorable prognosis.

Material and methods

This retrospective study included 198 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy. Information about age, extracranial spread, number of brain metastases, performance status and other variables was collected. Uni- and multivariate tests were performed.

Results

Median survival was 16.5 months (single brain metastasis) and 9.8 months (2–4, comparable survival for 2, 3 and 4), respectively (p = 0.001). After 5 years, 15 and 2% of the patients were still alive. In patients alive after 2 years, added median survival was 23 months and the probability of being alive 5 years after treatment was 26%. In multivariate analysis, extracranial metastases were not significantly associated with survival, while primary tumor control was.

Conclusion

Long-term survival beyond 5 years is possible in a minority of patients with oligometastatic brain disease, in particular those with a single brain metastasis. The presence of extracranial metastases to one site should not be regarded a barrier towards maximum brain-directed therapy.

Abstract

Aim

The aim of this study was to characterize the survival results of patients with up to four brain metastases after intense local therapy (primary surgery or stereotactic radiotherapy) if extracranial metastases were absent or limited to one site, e.g. the lungs.

Background

Oligometastatic disease has repeatedly been reported to convey a favorable prognosis.

Material and methods

This retrospective study included 198 German and Norwegian patients treated with individualized approaches, always including brain radiotherapy. Information about age, extracranial spread, number of brain metastases, performance status and other variables was collected. Uni- and multivariate tests were performed.

Results

Median survival was 16.5 months (single brain metastasis) and 9.8 months (2–4, comparable survival for 2, 3 and 4), respectively (p = 0.001). After 5 years, 15 and 2% of the patients were still alive. In patients alive after 2 years, added median survival was 23 months and the probability of being alive 5 years after treatment was 26%. In multivariate analysis, extracranial metastases were not significantly associated with survival, while primary tumor control was.

Conclusion

Long-term survival beyond 5 years is possible in a minority of patients with oligometastatic brain disease, in particular those with a single brain metastasis. The presence of extracranial metastases to one site should not be regarded a barrier towards maximum brain-directed therapy.

Get Citation

Keywords

Brain metastases; Oligometastases; Radiotherapy; Radiosurgery; Neurosurgery

About this article
Title

Long-term survival results after treatment for oligometastatic brain disease

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 3 (2020)

Pages

307-311

Published online

2020-05-01

DOI

10.1016/j.rpor.2020.03.001

Bibliographic record

Rep Pract Oncol Radiother 2020;25(3):307-311.

Keywords

Brain metastases
Oligometastases
Radiotherapy
Radiosurgery
Neurosurgery

Authors

Carsten Nieder
Mandy Hintz
Ilinca Popp
Angelika Bilger
Anca L. Grosu

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