Research Article
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Year 2019, Volume: 41 Issue: 4, 712 - 720, 31.12.2019

Eda Erdiş , Birsen Yücel

https://doi.org/10.7197/cmj.vi.643508

Abstract

References

  • 1. Usuki KY, Milano MT, David M, Okunieff P. Metastatic disease: bone, spinal cord, brain, liver, and lung. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology. 4nd ed. Elsevier Saunders; 2016. 443-45.
  • 2. Patchell RA. The management of brain metastases. Cancer Treat Rev 2003;29(6):533-40.
  • 3. Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 1997;37:745–51.
  • 4. Gerdan L, Segedin B, Nagy V, et al. Brain metastasis from non-small cell lung cancer: prognostic importance of the number of involved extracranial organs. Strahlenther Onkol 2014;190(1):64-7.
  • 5. Colt JS, Schwartz K, Graubard BI, et al. Hypertension and risk of renal cell carcinoma among white and black Americans. Epidemiology 2011;22:797–804.
  • 6. Virdis R, Balestrazzi P, Zampolli M et al. Hypertension in children with neurofibromatosis. Human Hypertension 1994;8: 395- 397.
  • 7. Edlinger M, Strohmaier S, Jonsson H, et al. Blood pressure and other metabolic syndrome factors and risk of brain tumour in the large population-based Me-Can cohort study. J Hypertens 2012;30(2):290-296.
  • 8.Weiss L, Haydock D, Pickren JW et al. Organ vascularity and metastatic frequency. Am J Path 1980; 101:101-113. 9. Braithwaite D, Tammemagi CM, Moore DH, Ozanne EM, Hiatt RA, Belkora J, West DW, Satariano WA, Liebman M, Esserman L. Hypertension is an independent predictor of survival disparity between African-American and white breast cancer patients. Int J Cancer 2009;124:1213–1219.
  • 10. Hua Xu, Li-min Zhang, Jun Liu et al. The association between overall survival of prostate cancer patients and hypertension, hyperglycemia, and overweight in Southern China: a prospective cohort study. J Cancer Res Clin Oncol 2013;139:943–951.
  • 11. Shaw E, Scott C, Souhami L, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 9005. Int J Radiat Oncol Biol Phys 2000; 47:291.
  • 12. Nieder C, Grosu AL, Spanne O, Andratschke NH, Geinitz H. Brain metastases in patients under 50 years of age: Retrospective analysis. ClinExp Metastasis 2012;29(8):949-56.
  • 13. Soffietti R, Cornu P, Delattre JY, Grant R, Graus F, Grisold W, et al. Brain metastases. In: Gilhus NE, Barnes MP, Brainin M (Ed). European Handbook of Neurological Management. 2nd ed. Oxford: Blackwell Publishing Ltd. 2011; 437-45.
  • 14. Hall WA, Djalilian HR, Nussbaum ES, Cho KH. Long-term survival with metastatic cancer to the brain. Med Oncol 2000;17(4):279-86.
  • 15. Aoyama H, Shirato H, Tago M, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 2006; 295:2483-91.
  • 16. Billings PS, Miller DL, Allen MS, et al. Surgical treatment of primary lung cancer with synchronous brain metastases. J Thorac Cardiovasc Surg 2001; 122: 548-53.
  • 17. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 1990; 322(8): 494-500.
  • 18. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ et al. Postoperative Radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 1998; 280(17): 1485-9.
  • 19. Vecht CJ, Haaxma-Reiche H, Noordijk EM, Padberg GW, Voormolen JH, Hoekstra FH, et al. Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery? Ann Neurol 1993; 33(6):583-90.
  • 20. Ferrara M, Bizzozzero L, Talamonti G et al. Surgical treatment of 100 single brain metastases. Analysis of the results. J Neurosurg Sci 1990; 34(3-4): 303-308.
  • 21. Duransoy YK, Selcuki M, Gokce T, Duransoy A. Prognostic Factors in Metastatic Brain Tumors: Study of 62 Patients. J Neurol Sci 2012; 29(4): 732-743.
  • 22. Bhatnagar AK, Flickinger JC, Kondziolka D, et al. Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat Oncol Biol Phys 2006; 64:898-903.
  • 23. Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 2004; 363:1665-72.
  • 24. Delattre JY, Krol G, Thaler HT et al. Distribution of brain metastaes. Arch Neurol 1988;45:741-744.
  • 25. Abe E. Sahmoun, L. Douglas Case, et al. Hypertension And Risk Of Brain Metastasis From Small Cell Lung Cancer: A Retrospective Follow-Up Study. Anticancer Research 2004; 24: 3115-120.
  • 26. Fisher ER, Hellstrom HR, Fisher b. Experimental study of relationship between hypertension and tumor growth and metastases. Br J Cancer 1968;22(2):342-45.
  • 27. Yancik R, Ries LA. Cancer in older persons: an international issue in an aging world. Semin Oncol. 2004;31(2):128–136.
  • 28. Cronin-Fenton DP, Nørgaard M, Jacobsen J, et al. Comorbidity and survival of Danish breast cancer patients from 1995 to 2005. Br J Cancer. 2007;96(9):1462–1468.
  • 29. Iversen LH, Nørgaard M, Jacobsen J, Laurberg S, Sørensen HT. The impact of comorbidity on survival of Danish colorectal cancer patients from 1995 to 2006 – a population-based cohort study. Dis Colon Rectum. 2009;52(1):71–78.
  • 30. Land LH, Dalton SO, Jensen MB, Ewertz M. Impact of comorbidity on mortality: a cohort study of 62,591 Danish women diagnosed with early breast cancer, 1990–2008. Breast Cancer Res Treat 2012;131(3): 1013–1020.
  • 31. Asmis TR, Ding K, Seymour L, et al; National Cancer Institute of Canada Clinical Trials Group. Age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of National Cancer Institute of Canada Clinical Trials Group trials. J Clin Oncol 2008;26(1):54–59.
  • 32. Roxburgh C, McDonald A, Salmond J, et al. Adjuvant chemotherapy for resected colon cancer: comparison of the prognostic value of tumour and patient related factors. Int J Colorectal Dis 2011;26(4):483–492.
  • 33. Sarfati D, Hill S, Blakely T, et al. The effect of comorbidity on the use of adjuvant chemotherapy and survival from colon cancer: a retrospec¬tive cohort study. BMC Cancer 2009;9:116.
  • 34. Grønberg BH, Sundstrøm S, Kaasa S, et al. Influence of comorbid¬ity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy. Eur J Cancer 2010;46(12):2225–2234.
  • 35. Lüchtenborg M, Jakobsen E, Krasnik M, Linklater KM, Mellemgaard A, Møller H. The effect of comorbidity on stage-specific survival in resected non-small cell lung cancer patients. Eur J Cancer 2012;48(18): 3386–3395.
  • 36. Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL Jr. Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA 2004;291(20):2441-7.
  • 37. Shin DW, Baik YJ, Kim YW, Oh JH, Chung KW, Kim SW, Lee WC, Yun YH, Cho J. Knowledge, attitudes, and practice on second primary cancer screening among cancer survivors: a qualitative study. Patient Educ Couns 2011; 85: 74–78.

The effect of hypertension on survival in patients undergoing radiotherapy for brain metastasis

Year 2019, Volume: 41 Issue: 4, 712 - 720, 31.12.2019

Eda Erdiş , Birsen Yücel

https://doi.org/10.7197/cmj.vi.643508

Abstract

Objective: The prognosis of brain metastasis is very poor and the
survival period is very short if the patient is not treated. The determination
of prognostic factors is important in order to avoid invasive treatment
interventions or unnecessary treatment in the management of patients with brain
metastases. In this study, prognostic factors and the effect of hypertension on
survival in patients with brain metastasis were investigated.

Method: In this study, the data of 463 patients diagnosed with
brain metastasis, who were admitted to Cumhuriyet University Radiation Oncology
department between 2007 and 2018, were retrospectively analyzed.

Results: The median age was 59 (18-82) years. There were 170
(37%) patients with comorbidity and 23% of these patients had hypertension in
their medical history. With regard to primary cancer diagnoses, 271 (58%)
patients had lung cancer, 91 (20%) breast, 31 (6%) gastrointestinal, 21 (5%)
genitourinary, 13 (3%) gynecological, 11 (2%) unknown cancer and 25 (5%) had
other types of cancer. At the time of diagnosis, 217 patients (47%) were in a
metastatic stage. Median survival was 4 months (0-130 months); mean survival
was 9.74 + 0.6 months; 1-year survival was 27% and 2-year survival was 13%. In
univariate analysis, gender (p = .001), age (p < .001), hypertension (p =
.018), primary diagnosis (p < .001), RPA (p < .001), number of lesions (p
< .001), SRS (p < .001), metastatectomy (p < .001) and primary disease
status (p = .002) were statistically significant. Multivariate analysis showed
that hypertension (HR: 1.29, 95%; CI: 1.02-1.71;                       p =  .027), age (HR: 1.39, 95%; CI: 1.08-1.77; p =
.008), primary diagnosis (HR: 1.63, 95%; CI: 1.20 -2.23; p = .002), RPA (HR:
2.05, 95%; CI: 1.35-3.09; p = .001), metastatectomy (HR: 0.63, 95%; CI:
0.46-0.86; p = .004) and SRS (HR: 0.53, 95%; CI: 0.38-0.72, p < .001) were
independent prognostic factors.







Conclusions:
In
this study, the presence of hypertension was as important in the prognosis of
the disease as primary diagnosis, age, metastatectomy and SRS.

Keywords

Brain metastases prognostic factors survival hypertension

References

  • 1. Usuki KY, Milano MT, David M, Okunieff P. Metastatic disease: bone, spinal cord, brain, liver, and lung. In: Gunderson LL, Tepper JE, editors. Clinical radiation oncology. 4nd ed. Elsevier Saunders; 2016. 443-45.
  • 2. Patchell RA. The management of brain metastases. Cancer Treat Rev 2003;29(6):533-40.
  • 3. Gaspar L, Scott C, Rotman M, et al. Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 1997;37:745–51.
  • 4. Gerdan L, Segedin B, Nagy V, et al. Brain metastasis from non-small cell lung cancer: prognostic importance of the number of involved extracranial organs. Strahlenther Onkol 2014;190(1):64-7.
  • 5. Colt JS, Schwartz K, Graubard BI, et al. Hypertension and risk of renal cell carcinoma among white and black Americans. Epidemiology 2011;22:797–804.
  • 6. Virdis R, Balestrazzi P, Zampolli M et al. Hypertension in children with neurofibromatosis. Human Hypertension 1994;8: 395- 397.
  • 7. Edlinger M, Strohmaier S, Jonsson H, et al. Blood pressure and other metabolic syndrome factors and risk of brain tumour in the large population-based Me-Can cohort study. J Hypertens 2012;30(2):290-296.
  • 8.Weiss L, Haydock D, Pickren JW et al. Organ vascularity and metastatic frequency. Am J Path 1980; 101:101-113. 9. Braithwaite D, Tammemagi CM, Moore DH, Ozanne EM, Hiatt RA, Belkora J, West DW, Satariano WA, Liebman M, Esserman L. Hypertension is an independent predictor of survival disparity between African-American and white breast cancer patients. Int J Cancer 2009;124:1213–1219.
  • 10. Hua Xu, Li-min Zhang, Jun Liu et al. The association between overall survival of prostate cancer patients and hypertension, hyperglycemia, and overweight in Southern China: a prospective cohort study. J Cancer Res Clin Oncol 2013;139:943–951.
  • 11. Shaw E, Scott C, Souhami L, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 9005. Int J Radiat Oncol Biol Phys 2000; 47:291.
  • 12. Nieder C, Grosu AL, Spanne O, Andratschke NH, Geinitz H. Brain metastases in patients under 50 years of age: Retrospective analysis. ClinExp Metastasis 2012;29(8):949-56.
  • 13. Soffietti R, Cornu P, Delattre JY, Grant R, Graus F, Grisold W, et al. Brain metastases. In: Gilhus NE, Barnes MP, Brainin M (Ed). European Handbook of Neurological Management. 2nd ed. Oxford: Blackwell Publishing Ltd. 2011; 437-45.
  • 14. Hall WA, Djalilian HR, Nussbaum ES, Cho KH. Long-term survival with metastatic cancer to the brain. Med Oncol 2000;17(4):279-86.
  • 15. Aoyama H, Shirato H, Tago M, et al. Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. JAMA 2006; 295:2483-91.
  • 16. Billings PS, Miller DL, Allen MS, et al. Surgical treatment of primary lung cancer with synchronous brain metastases. J Thorac Cardiovasc Surg 2001; 122: 548-53.
  • 17. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ et al. A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 1990; 322(8): 494-500.
  • 18. Patchell RA, Tibbs PA, Walsh JW, Dempsey RJ, Maruyama Y, Kryscio RJ et al. Postoperative Radiotherapy in the treatment of single metastases to the brain: a randomized trial. JAMA 1998; 280(17): 1485-9.
  • 19. Vecht CJ, Haaxma-Reiche H, Noordijk EM, Padberg GW, Voormolen JH, Hoekstra FH, et al. Treatment of single brain metastasis: radiotherapy alone or combined with neurosurgery? Ann Neurol 1993; 33(6):583-90.
  • 20. Ferrara M, Bizzozzero L, Talamonti G et al. Surgical treatment of 100 single brain metastases. Analysis of the results. J Neurosurg Sci 1990; 34(3-4): 303-308.
  • 21. Duransoy YK, Selcuki M, Gokce T, Duransoy A. Prognostic Factors in Metastatic Brain Tumors: Study of 62 Patients. J Neurol Sci 2012; 29(4): 732-743.
  • 22. Bhatnagar AK, Flickinger JC, Kondziolka D, et al. Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat Oncol Biol Phys 2006; 64:898-903.
  • 23. Andrews DW, Scott CB, Sperduto PW, et al. Whole brain radiation therapy with or without stereotactic radiosurgery boost for patients with one to three brain metastases: phase III results of the RTOG 9508 randomised trial. Lancet 2004; 363:1665-72.
  • 24. Delattre JY, Krol G, Thaler HT et al. Distribution of brain metastaes. Arch Neurol 1988;45:741-744.
  • 25. Abe E. Sahmoun, L. Douglas Case, et al. Hypertension And Risk Of Brain Metastasis From Small Cell Lung Cancer: A Retrospective Follow-Up Study. Anticancer Research 2004; 24: 3115-120.
  • 26. Fisher ER, Hellstrom HR, Fisher b. Experimental study of relationship between hypertension and tumor growth and metastases. Br J Cancer 1968;22(2):342-45.
  • 27. Yancik R, Ries LA. Cancer in older persons: an international issue in an aging world. Semin Oncol. 2004;31(2):128–136.
  • 28. Cronin-Fenton DP, Nørgaard M, Jacobsen J, et al. Comorbidity and survival of Danish breast cancer patients from 1995 to 2005. Br J Cancer. 2007;96(9):1462–1468.
  • 29. Iversen LH, Nørgaard M, Jacobsen J, Laurberg S, Sørensen HT. The impact of comorbidity on survival of Danish colorectal cancer patients from 1995 to 2006 – a population-based cohort study. Dis Colon Rectum. 2009;52(1):71–78.
  • 30. Land LH, Dalton SO, Jensen MB, Ewertz M. Impact of comorbidity on mortality: a cohort study of 62,591 Danish women diagnosed with early breast cancer, 1990–2008. Breast Cancer Res Treat 2012;131(3): 1013–1020.
  • 31. Asmis TR, Ding K, Seymour L, et al; National Cancer Institute of Canada Clinical Trials Group. Age and comorbidity as independent prognostic factors in the treatment of non small-cell lung cancer: a review of National Cancer Institute of Canada Clinical Trials Group trials. J Clin Oncol 2008;26(1):54–59.
  • 32. Roxburgh C, McDonald A, Salmond J, et al. Adjuvant chemotherapy for resected colon cancer: comparison of the prognostic value of tumour and patient related factors. Int J Colorectal Dis 2011;26(4):483–492.
  • 33. Sarfati D, Hill S, Blakely T, et al. The effect of comorbidity on the use of adjuvant chemotherapy and survival from colon cancer: a retrospec¬tive cohort study. BMC Cancer 2009;9:116.
  • 34. Grønberg BH, Sundstrøm S, Kaasa S, et al. Influence of comorbid¬ity on survival, toxicity and health-related quality of life in patients with advanced non-small-cell lung cancer receiving platinum-doublet chemotherapy. Eur J Cancer 2010;46(12):2225–2234.
  • 35. Lüchtenborg M, Jakobsen E, Krasnik M, Linklater KM, Mellemgaard A, Møller H. The effect of comorbidity on stage-specific survival in resected non-small cell lung cancer patients. Eur J Cancer 2012;48(18): 3386–3395.
  • 36. Piccirillo JF, Tierney RM, Costas I, Grove L, Spitznagel EL Jr. Prognostic importance of comorbidity in a hospital-based cancer registry. JAMA 2004;291(20):2441-7.
  • 37. Shin DW, Baik YJ, Kim YW, Oh JH, Chung KW, Kim SW, Lee WC, Yun YH, Cho J. Knowledge, attitudes, and practice on second primary cancer screening among cancer survivors: a qualitative study. Patient Educ Couns 2011; 85: 74–78.
There are 36 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Eda Erdiş 0000-0003-3003-8643

Birsen Yücel

Publication Date December 31, 2019
Acceptance Date November 28, 2019
Published in Issue Year 2019Volume: 41 Issue: 4

Cite

AMA Erdiş E, Yücel B. The effect of hypertension on survival in patients undergoing radiotherapy for brain metastasis. CMJ. December 2019;41(4):712-720. doi:10.7197/cmj.vi.643508