Radiation therapy for epithelial ovarian cancer brain metastases: clinical outcomes and predictors of survivalReport as inadecuate

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Radiation Oncology

, 8:36

First Online: 15 February 2013Received: 24 August 2012Accepted: 09 February 2013DOI: 10.1186-1748-717X-8-36

Cite this article as: Teckie, S., Makker, V., Tabar, V. et al. Radiat Oncol 2013 8: 36. doi:10.1186-1748-717X-8-36


BackgroundBrain metastases BM and leptomeningeal disease LMD are uncommon in epithelial ovarian cancer EOC. We investigate the outcomes of modern radiation therapy RT as a primary treatment modality in patients with EOC BM and LMD.

MethodsWe evaluated 60 patients with EOC treated at our institution from 1996 to 2010 who developed BM. All information was obtained from chart review.

ResultsAt EOC diagnosis, median age was 56.1 years and 88% of patients were stage III-IV. At time of BM diagnosis, 46.7% of patients had 1 BM, 16.7% had two to three, 26.7% had four or more, and 10% had LMD. Median follow-up after BM was 9.3 months range, 0.3-82.3. All patients received RT, and 37% had surgical resection. LMD occurred in the primary or recurrent setting in 12 patients 20%, 9 of whom received RT. Median overall survival OS after BM was 9.7 months for all patients 95% CI 5.9–13.5, and 16.1 months 95% CI 3.8-28.3 in patients with one BM. On multivariate analysis, Karnofsky performance status less than 70 hazard ratio HR 2.86, p = 0.018, four or more BM HR 3.18, p = 0.05, LMD HR 8.22, p = 0.013, and uncontrolled primary tumor HR 2.84, p = 0.008 were significantly associated with inferior OS. Use of surgery was not significant p = 0.31. Median central nervous system freedom from progression CNS-FFP in 47 patients with follow-up was 18.5 months 95% CI, 9.3–27.9. Only four or more BM HR 2.56, p = 0.04 was significantly associated with poorer CNS-FFP.

ConclusionsBased on our results, RT appears to be an effective treatment modality for brain metastases from EOC and should be routinely offered. Karnofsky performance status less than 70, four or more BM, LMD, and uncontrolled primary tumor predict for worse survival after RT for EOC BM. Whether RT is superior to surgery or chemotherapy for EOC BM remains to be seen in a larger cohort.

KeywordsOvarian cancer Brain metastases Leptomeningeal disease Palliation AbbreviationsBMBrain metastases

LMDLeptomeningeal disease

EOCEpithelial ovarian cancer

RTRadiation therapy

KPSKarnofsky performance status

CNSCentral nervous system

WBRTWhole brain radiation therapy

PBRTPartial brain radiation therapy

SRSStereotactic radiosurgery

OSOverall survival

PFSProgression free survival

FFPFreedom from progression

MVAMultivariate analysis

UVAUnivariate analysis

HRHazard ratio

RPARecursive partitioning analysis

Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-8-36 contains supplementary material, which is available to authorized users.

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Author: Sewit Teckie - Vicky Makker - Viviane Tabar - Kaled Alektiar - Carol Aghajanian - Martee Hensley - Kathryn Beal

Source: https://link.springer.com/

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