التفاصيل البيبلوغرافية
| العنوان: |
Impact of radiotherapy administered simultaneously with systemic treatment in patients with melanoma brain metastases within MelBase, a French multicentric prospective cohort. |
| المؤلفون: |
Tétu, Pauline1 (AUTHOR) pauline.tetu@hotmail.fr, Allayous, Clara1 (AUTHOR), Oriano, Bastien2 (AUTHOR), Dalle, Stéphane3 (AUTHOR), Mortier, Laurent4 (AUTHOR), Leccia, Marie-Thérèse5 (AUTHOR), Guillot, Bernard6 (AUTHOR), Dalac, Sophie7 (AUTHOR), Dutriaux, Caroline8 (AUTHOR), Lacour, Jean-Philippe9 (AUTHOR), Saiag, Philippe10 (AUTHOR), Brunet-Possenti, Florence11 (AUTHOR), De Quatrebarbes, Julie12 (AUTHOR), Stoebner, Pierre-Emmanuel13 (AUTHOR), Legoupil, Delphine14 (AUTHOR), Beylot-Barry, Marie15 (AUTHOR), Lesimple, Thierry16 (AUTHOR), Aubin, François17 (AUTHOR), Dreno, Brigitte18 (AUTHOR), Mohamed, Sameh1 (AUTHOR) |
| المصدر: |
European Journal of Cancer. May2019, Vol. 112, p38-46. 9p. |
| مصطلحات موضوعية: |
*BRAIN tumors, *CANCER patients, *COMBINED modality therapy, *CONFIDENCE intervals, *IMMUNOTHERAPY, *LONGITUDINAL method, *MEDICAL care, *MEDICAL cooperation, *MELANOMA, *METASTASIS, *PATIENTS, *RADIOTHERAPY, *RESEARCH, *SURVIVAL analysis (Biometry), *TREATMENT effectiveness, *DESCRIPTIVE statistics |
| مستخلص: |
Melanoma brain metastases (MBMs) are historically associated with poor prognosis. Radiation therapy is conventionally associated with a high local control rate. Development of targeted therapy and immunotherapy has improved overall survival (OS) and intracranial response rate, but about 50% of patients failed to respond to these novel therapies. The objective of this study was to assess the impact of combined radiotherapy (cRT) on overall survival in a large multicenter real-life prospective cohort of patients with MBM treated with immunotherapy or targeted therapy. Clinical data from 262 patients with MBM were collected via MelBase, a French multicentric biobank prospectively enrolling unresectable stage III or IV melanoma. Two groups were defined: patients receiving cRT (cRT group) or not receiving cRT (no-cRT group). Primary end-point was OS. Propensity score weighting was used to correct for indication bias. Among the 262 patients, 93 (35%) received cRT (cRT group). The patients were treated with immunotherapy in 69% and 60% and with targeted therapy in 31% and 40% of the cRT and no-cRT groups, respectively. With a median follow-up of 6.9 months, median OS was 16.8 months and 6.9 months in the cRT and no-cRT groups, respectively. After propensity score weighting, cRT was associated with longer OS (hazard ratio = 0.6, 95% confidence interval: 0.4–0.8; p=0.007). Median OS after ponderation was 15.3 months and 6.2 months in the cRT and no-cRT groups, respectively. This study shows that cRT may be associated with a significant decrease of 40% in the risk of death in patients with MBM treated with systemic therapy. • This is a prospective multicenter observational cohort of advanced melanoma. • Propensity scores are used to limit confusion and selection bias. • Combined radiotherapy (cRT) increased overall survival in patients with brain metastases. • cRT and systemic therapy decreased the risk of death by 40%. • cRT and new systemic therapies may be synergistic. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
Academic Search Index |
