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Cystic brain metastases had slower speed of tumor shrinkage but similar prognosis compared with solid tumors that underwent radiosurgery treatment

Authors Wang H, Liu X, Jiang X, Song Y, Wang X, Wang J, Dong Y, Li F, Wu Z, Zhang Y, Yuan Z

Received 25 September 2018

Accepted for publication 7 January 2019

Published 20 February 2019 Volume 2019:11 Pages 1753—1763

DOI https://doi.org/10.2147/CMAR.S188674

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Ahmet Emre Eskazan


Hui Wang,* Xiaoye Liu,* Xuechao Jiang, Yongchun Song, Xiaoguang Wang, Jingsheng Wang, Yang Dong, Fengtong Li, Zhiqiang Wu, Yuhan Zhang, Zhiyong Yuan

Department of Radiation Oncology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China

*These authors contributed equally to this work

Purpose: Traditionally, radiosurgery was considered less effective for patients with cystic brain metastases. However, comparisons of prognosis between cystic and solid brain metastases in cancer patients have been seldom reported. We aimed to compare the survival between cystic and solid brain metastases and assess risk factors for overall survival after brain metastases (BMOS) in patients who underwent radiosurgery treatment.
Patients and methods: The Kaplan–Meier method and multivariate Cox regression analysis were used to compare survival time and evaluate risk factors for BMOS.
Results: A total of 356 patients (including 498 brain metastases) were analyzed in our study, including 67 patients (67/356, 18.8%) with 75 cystic brain metastases. There is no statistical significance in BMOS between patients with cystic (17 months, range: 3–64 months) and solid (17.5 months, range: 1–65 months) brain metastases (P=0.148). However, the volume of cystic brain metastases decreased more slowly than solid brain metastases (P<0.05). The results indicated that high recursive partitioning analysis classification (P=0.006), large volume of brain metastases (P=0.006), and different primary lesion (especially gastrointestinal tract tumor) (P=0.001) were associated with poor prognosis in patients with brain metastases.
Conclusion: There is no difference in prognosis and local control between patients with cystic and solid brain metastases who underwent radiosurgery. However, the rate and speed of tumor shrinkage were lower in cystic brain metastases after radiotherapy. Patients with larger brain metastases had shorter survival time, regardless of cystic or solid brain metastases.

Keywords: cystic brain metastases, radiosurgery treatment, tumor shrinkage, overall survival after brain metastases, risk factors

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