eLife · 2024
Amphibian mast cells serve as barriers to chytrid fungus infections.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Hauser Kelsey A, Garvey Christina N, Crow Ryley S, Hossainey Muhammad R H, Howard Dustin T, Ranganathan Netra, Gentry Lindsey K, Yaparla Amulya, Kalia Namarta, Zelle Mira, Jones Elizabeth J, Duttargi Anju N, Rollins-Smith Louise A, Muletz-Wolz Carly R, Grayfer Leon
Аннотация
BACKGROUND: Brain metastases (BM) are a major complication in metastatic breast cancer, especially in HER2-positive and triple-negative subtypes. Despite advances in systemic therapy, BM remains associated with a poor prognosis and often requires radiotherapy. This study evaluates the outcomes of brain irradiation across subtypes and proposes a prognostic scoring system to guide treatment.
METHODS: This retrospective study analyzed data from 348 breast cancer patients with BM to develop a prognostic scoring system for radiotherapy decisions. The data included molecular subtypes, number of brain lesions, and survival outcomes. Kaplan-Meier and Cox proportional hazards models were used to identify prognostic factors. The scoring system, based on the significance of predictors, was compared with physician-selected radiotherapy techniques to assess its potential for optimizing care.
RESULTS: Luminal breast cancer was most prevalent (42.6%), followed by HER2-positive and triple-negative (19% each). Median BM onset was 23 months; headache was the most common symptom (48%). HER2-positive and triple-negative patients developed metastases earlier than luminal and triple-positive (P=0.001). Survival was better for luminal and triple-positive, poorer for HER2-positive and triple-negative. Patients with fewer than five brain lesions had higher survival rates (P=0.001). The scoring system incorporated molecular subtype, lesion burden, and patient characteristics. Scores above 3.5 predicted worse survival, with higher scores strongly linked to poorer outcomes (P=0.001).
CONCLUSION: This study identifies key prognostic factors influencing survival in breast cancer patients with BM and proposes a scoring system to guide radiotherapy decisions. Molecular subtypes, metastatic burden, and clinical characteristics significantly affect outcomes, with HER2-positive and triple-negative subtypes showing the poorest survival. The system provides a structured approach for treatment selection, though further validation is needed to ensure its accuracy and clinical utility in personalized radiotherapy planning.
METHODS: This retrospective study analyzed data from 348 breast cancer patients with BM to develop a prognostic scoring system for radiotherapy decisions. The data included molecular subtypes, number of brain lesions, and survival outcomes. Kaplan-Meier and Cox proportional hazards models were used to identify prognostic factors. The scoring system, based on the significance of predictors, was compared with physician-selected radiotherapy techniques to assess its potential for optimizing care.
RESULTS: Luminal breast cancer was most prevalent (42.6%), followed by HER2-positive and triple-negative (19% each). Median BM onset was 23 months; headache was the most common symptom (48%). HER2-positive and triple-negative patients developed metastases earlier than luminal and triple-positive (P=0.001). Survival was better for luminal and triple-positive, poorer for HER2-positive and triple-negative. Patients with fewer than five brain lesions had higher survival rates (P=0.001). The scoring system incorporated molecular subtype, lesion burden, and patient characteristics. Scores above 3.5 predicted worse survival, with higher scores strongly linked to poorer outcomes (P=0.001).
CONCLUSION: This study identifies key prognostic factors influencing survival in breast cancer patients with BM and proposes a scoring system to guide radiotherapy decisions. Molecular subtypes, metastatic burden, and clinical characteristics significantly affect outcomes, with HER2-positive and triple-negative subtypes showing the poorest survival. The system provides a structured approach for treatment selection, though further validation is needed to ensure its accuracy and clinical utility in personalized radiotherapy planning.