DOI: https://doi.org/10.22263/2312-4156.2023.4.66
A.G. Chyzh, P.D. Dziameshka, V.A. Hizemava
The outcomes of treating patients with resectable brain metastases
N.N. Alexandrov National Cancer Centre of Belarus, Minsk, Republic of Belarus
Vestnik VGMU. 2023;22(4):66-77.
Abstract.
Objectives. To study the effectiveness of resectable brain metastases treatment in a large cohort of patients and to evaluate the complications rate after it.
Material and methods. We have analysed publications dedicated to brain metastases therapy and our own experience in N.N. Alexandrov National Cancer Centre of Belarus. We included in our study 124 patients for whom surgical resection was performed during the period from 2011 to 2018. Adjuvant whole brain radiation therapy was used for radiosensitive tumors. The indices of overall survival (OS) and cumulative incidence of local recurrence were assessed. Treatment complications rate was studied as well.
Results. Median duration of the patients’ follow-up was 48.6 months. Cumulative incidence of local recurrences in the studied group for 6, 12 and 24 months was 23.5%±3.9%, 39.8%±4.7% and 48.5%±5.1%. Median time of local recurrence appearance made up 5.1 months. Leptomeningeal dissemination was revealed in 10 patients (8.1%).
Median OS for the entire cohort was 17.1 months. The highest levels of OS were achieved in patients with renal cancer (median OS – 23.9 months). In patients with non-small cell lung cancer, breast cancer, melanoma and other tumor medians of OS made up 18.8, 20.5, 10.7 and 14.0 months, accordingly. Complications rate was 10.5% (13 patients), all complications observed were less than grade 3 according to the Clavien - Dindo classification.
Conclusions. The results of therapy for resectable brain metastases in a large cohort of patients have been demonstrated. Relatively good OS indices were achieved after standard combined therapy (surgical resection and whole brain radiation therapy). At the same time such therapy is associated with a high risk of cognitive-mnestic functions disturbances and low rate of local control. For these reasons it’s important to search for alternative variants of combined therapy for brain metastases.
Keywords: cerebral metastases, surgical resection, combined therapy, radiation therapy.
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Information about authors:
A.G. Chyzh – neurosurgeon, N.N. Alexandrov National Cancer Centre of Belarus, https://orcid.org/0000-0003-0182-2308
e-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Andrey G. Chyzh;
P.D. Dziameshka – Doctor of Medical Sciences, associate professor, principal research officer of the radiation therapy laboratory, N.N. Alexandrov National Cancer Centre of Belarus, https://orcid.org/0000-0002-1324-3656
V.A. Hizemava – Candidate of Medical Sciences, radiation oncologist, N.N. Alexandrov National Cancer Centre of Belarus, https://orcid.org/0000-0002-9724-6925
