Browsing by Subject "Brain metastases"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Publication
    Restricted
    Antiseizure medication for brain metastasis-related epilepsy: Findings of optimal choice from a retrospective cohort
    (Elsevier, 2021-11-19) Sánchez-Villalobos, José Manuel; Aledo-Serrano, Ángel; Serna-Berna, Alfredo; Salinas-Ramos, Juan; Martínez Alonso, Emma; Pérez-Vicente, José Antonio; Alcaraz Baños, Miguel; Biología Celular e Histología; Facultad de Medicina
    Objective: To analyze the prevalence of antiseizure medication (ASM) in patients with brain metastasis-related epilepsy (BMRE) treated with radiosurgery and the relationship between ASM and psychiatric comorbidity. Material and methods: This is a cross-sectional observational design study with retrospective review of medical records of all patients with brain metastases treated with volumetric modulated arc therapy radiosurgery (VMAT-RS) between 2012 and 2018 in a tertiary oncology center. We included those patients with BMRE, analyzing the clinical and demographic data, with special attention to psychiatric comorbidities and the use of ASM. Results: Of the 121 patients with brain metastases included for treatment with VMAT-RS, a total of 38 presented BMRE. The most widely used ASM as first-line treatment was levetiracetam (89%). Only 8% of the patients received sodium channel blockers. The most common psychiatric comorbidity was depression (42.1%). Conclusions: Levetiracetam is the most widely used ASM in patients with BMRE treated with VMAT-RS. Nevertheless, common psychiatric comorbidities in this population might change the decision-making of ASM choice.
  • Thumbnail Image
    Publication
    Open Access
    Clinical subtypes in breast cancer patients with brain metastases from an ambispective registry of advanced breast cancer, GEICAM/2014-03 (RegistEM)
    (2026-02-20) López Tarruella, Sara ; Guerrero-Zotano, Ángel ; Antolín, Silvia ; Cruz, Josefina ; Martínez, Purificación ; Rodríguez, César A.; Falo, Catalina ; Rodríguez Lescure, Álvaro ; Adrover, Encarna ; Hernández, María ; Andrés, Raquel ; Chacón, José Ignacio ; Alonso Romero, José Luis; Miguel, Ana ; Gómez Raposo, César ; Margelí, Mireia ; González, Iria ; Guerra, José Antonio; Antón, Antonio ; Tibau, Ariadna ; Miralles, Juan José; Escudero, María José; Bezares, Susana ; Rojo, Federico ; Álvarez, Isabel ; Medicina Interna; Facultades de la UMU::Facultad de Medicina
    Background: Breast cancer frequently results in brain metastases (BCBM), leading to poor outcomes. Central nervous system (CNS) involvement entails significant challenges in advanced breast cancer (ABC) patients. Objectives: To characterize BCBM patients according to surrogate clinical BC subtypes and evaluate the interval between ABC and BCBM detection, both at ABC diagnosis (BCBM1 cohort) and for those who develop BCBM subsequently (BCBM2 cohort). Secondary objectives included analyzing the time-related outcomes by BC subtype. Design: RegistEM is an ongoing ambispective, observational study of ABC patients diagnosed since January/2016. Methods: We describe the characteristics of BCBM patients reported by January 22, 2024, categorized by BC subtype on the most recent tumor sample obtained before first-line therapy. Results: At the cutoff date, 346/1947 (18%) patients diagnosed with ABC between January/2016 and December/2019 developed BCBM, and 288/346 (83%) died. All patients were female, predominantly Caucasian (98%), with a median age of 55 years at ABC diagnosis. The distribution by subtype was 170/346 (49%) HR+/HER2−, 68/346 (20%) HR+/HER2+, 54/346 (16%) HR−/HER2+, and 51/346 (15%) HR−/HER2− (triple negative (TN)). One-fourth (85/346) were in the BCBM1 cohort, with 22/85 (26%) having BCBM as the only metastatic location; in this cohort, median time to BCBM was 38 months, with shorter intervals in HR−/HER2+ and TN subtypes (17 and 18 months, respectively). In the BCBM2 cohort (261/346), the median time to BCBM was 24 months, with the shortest interval in TN (13 months). Median survival from BCBM diagnosis was 26 months (95% confidence interval (CI), 20−35) in BCBM1 and 9 months (95% CI, 7−12) in BCBM2 (hazard ratio, 2.3; 95% CI, 1.7−3.0); TN subtype showed the poorest results (median of 6 months; 95% CI, 3−13). Conclusion: TN and HER2+ BC subtypes progressed faster to BCBM and had worse outcomes. Survival differed significantly between the two cohorts, BCBM1 and BCBM2. Continued research is essential to improve the treatment and prevention strategies.