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Metastatic melanoma: prognostic factors and survival in patients with brain metastases.
Frinton, E; Tong, D; Tan, J; Read, G; Kumar, V; Kennedy, S; Lim, C; Board, R E.
Afiliación
  • Frinton E; University of Manchester, Manchester, UK.
  • Tong D; Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, PR2 9HT, UK.
  • Tan J; Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, PR2 9HT, UK.
  • Read G; Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, PR2 9HT, UK.
  • Kumar V; Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, PR2 9HT, UK.
  • Kennedy S; Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, PR2 9HT, UK.
  • Lim C; Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, PR2 9HT, UK.
  • Board RE; Lancashire Teaching Hospitals NHS Trust, Royal Preston Hospital, Preston, PR2 9HT, UK. Ruth.Board@lthtr.nhs.uk.
J Neurooncol ; 135(3): 507-512, 2017 Dec.
Article en En | MEDLINE | ID: mdl-28819707
Brain metastases from malignant melanoma carry a poor prognosis. Novel systemic agents have improved overall survival (OS), but the value of whole-brain radiotherapy (WBRT) and stereotactic radiosurgery (SRS) remains uncertain. The melanoma-specific graded prognostic assessment (msGPA) provides useful prognostic information, but the relevance to the modern-day population has not been validated. Since 2011, 53 patients received treatment for brain metastases from malignant melanoma at the Rosemere Cancer Centre medical oncology clinic. Data were collated on demographic factors and survival. Survival analyses were performed using Kaplan-Meier methods. Cox regression was used to identify prognostic factors on univariate and multivariate analysis. OS from the date of diagnosis of brain metastases was 4.83 months (range 0.27-30.4 months). On univariate analysis, BRAF, performance status and msGPA were significant prognostic indicators for OS (p = 0.0056, p = 0.0039 and p = 0.0001 respectively). msGPA remained significant on multivariate analysis (p = 0.0006). OS for BRAF-positive patients receiving targeted treatment (n = 22) was significantly better than for BRAF-negative patients (n = 26), with median survival times of 8.2 and 3.7 months respectively (p = 0.0039, HR 2.36). SRS combined with systemic agents (n = 16) produced an OS of 13.5 months. Patients receiving WBRT alone (n = 21) had a poor prognosis (2.2 months). The msGPA remains a valid prognostic indicator in the era of novel systemic treatments for melanoma. BRAF-positive patients receiving targeted agents during their treatment had favorable survival outcomes. WBRT alone should be use with caution in the active management of melanoma brain metastases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Melanoma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Encefálicas / Melanoma Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurooncol Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos