In: NEOPLASMA, vol. 52, no. 2
I. Panagiotou - E. Brountzos - D. Kelekis - M. Papathanasiou - D. Bafaloukos
Detaily:
Rok, strany: 2005, 150 - 158
O článku:
The aim of our study was to analyze prognostic factors, effect of
treatment and survival outcome of a contemporary cohort of
melanoma patients with cerebral metastases and eventually propose
new recommendations regarding therapy.
Sixty four patients with melanoma brain metastases were treated in
our department within a 15-year period. We performed a
retrospective analysis of their survival with respect to the type
of treatment instituted. Four groups were formed according to
treatment: Group A patients treated with surgery followed by
radiotherapy; group B temozolomide as first-line treatment and
radiotherapy after cerebral disease progression; group C
radiotherapy alone; group D supportive care only.
Patients* characteristics influenced the selection of treatment
modality: Group A (7.8%) patients with a single brain metastasis
(p=0.001) and controlled extra-cranial disease (p<0.0001), while
Group D (21.8%) patients with ulcerated primary lesions (p=0.010)
and uncontrolled extra-cranial disease (p<0.0001). Only group B
(26.6%) and C (43.7%) patients with similar characteristics
including more than one brain lesion. Median overall survival was
3 months. In univariate analysis, median survival for groups A, B,
C and D was 12, 5, 3 and 2 months, respectively (p<0.0001). The
survival difference between the surgery and non-surgery groups was
statistically significant (p=0.0011). Patients treated with
supportive care had the worse prognosis (p<0.0001). A survival
benefit for patients receiving first-line treatment with
temozolomide, as compared to those receiving radiotherapy alone
was noted (p=0.0267). In multivariate survival analysis, the
number of brain lesions (p=0.0138), the absence of uncontrolled
extra-cranial disease (p=0.00221) and the type of treatment for
the cerebral disease (p=0.0053) remained significant independent
survival predictors.
Patients' characteristics remain a critical factor for treatment
selection. The number of brain metastases, the extent of disease
and the type of treatment represent independent survival
predictors. Melanoma patients with a single brain metastasis and
controlled extra-cranial disease gain a survival benefit, if
surgically treated. Including temozolomide in the first-line
treatment of melanoma patients with brain metastases who would
have been treated with radiotherapy alone, might present a
promising future direction affecting the length of survival.
Ako citovať:
ISO 690:
Panagiotou, I., Brountzos, E., Kelekis, D., Papathanasiou, M., Bafaloukos, D. 2005. Cerebral metastases of malignant melanoma: contemporary treatment
modalities and survival outcome. In NEOPLASMA, vol. 52, no.2, pp. 150-158. 0028-2685.
APA:
Panagiotou, I., Brountzos, E., Kelekis, D., Papathanasiou, M., Bafaloukos, D. (2005). Cerebral metastases of malignant melanoma: contemporary treatment
modalities and survival outcome. NEOPLASMA, 52(2), 150-158. 0028-2685.