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Review ArticleReviewsR

Recent Trends in Epidemiology of Brain Metastases: An Overview

EMELINE TABOURET, OLIVIER CHINOT, PHILIPPE METELLUS, AGNÈS TALLET, PATRICE VIENS and ANTHONY GONÇALVES
Anticancer Research November 2012, 32 (11) 4655-4662;
EMELINE TABOURET
1AP-HM, Timone Hospital, Departement of Neuro-oncology and Neuro-surgery, Marseille, France
3Aix-Marseille Université, Marseille, France
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OLIVIER CHINOT
1AP-HM, Timone Hospital, Departement of Neuro-oncology and Neuro-surgery, Marseille, France
3Aix-Marseille Université, Marseille, France
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PHILIPPE METELLUS
1AP-HM, Timone Hospital, Departement of Neuro-oncology and Neuro-surgery, Marseille, France
3Aix-Marseille Université, Marseille, France
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AGNÈS TALLET
2Institut Paoli-Calmettes, Departement of Medical Oncology, Marseille, France
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PATRICE VIENS
2Institut Paoli-Calmettes, Departement of Medical Oncology, Marseille, France
3Aix-Marseille Université, Marseille, France
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ANTHONY GONÇALVES
2Institut Paoli-Calmettes, Departement of Medical Oncology, Marseille, France
3Aix-Marseille Université, Marseille, France
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  • For correspondence: goncalvesa@ipc.unicancer.fr
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Abstract

Brain metastases (BM) are the most common intracranial neoplasm in adults. Initially considered as an essentially terminal stage of advanced cancer, BM are increasingly being recognized as an emerging area of clinical interest. Their epidemiological characteristics have changed significantly, including an increased incidence in tumors frequently associated with BM, such as lung and breast cancer or melanoma, but also a more frequent occurrence with other primary tumor entities such as renal, colorectal and ovarian cancer. BM are more commonly diagnosed in multiple intracerebral sites, but in the context of controlled extracranial disease. Accordingly, progress in the development of systemic treatments, together with the rationalized use of surgical resection, radiosurgery and whole-brain radiotherapy, have led to an increase in the number of long-term survivors and in median survival. The recent emergence of targeted therapies and growing knowledge regarding the specific biology of BM should allow further improvements in prognosis of this devastating disease.

  • Brain metastases
  • epidemiology
  • breast cancer
  • lung cancer
  • review

Brain metastases (BM) are the most common intracranial neoplasms in adults (1, 2). Classically, diagnosis of BM was considered to represent a poor prognosis event for patients, frequently corresponding to the initiation of the terminal phase of the disease. The estimated overall survival was short and therapeutic options were often palliative and with limited, intent (3). Improvements in local procedures combined with the increasing availability of systemic treatments, including emerging targeted therapeutics, have substantially modified the prognosis and survival of patients with BM (4). Indeed, the number of potentially active therapeutic lines is increasing and available therapies may control many metastatic tumors for months or even years (5). Accordingly, although the incidence of cancer is generally stable, mortality rates are declining, while the median survival duration has been improved in advanced stages (3, 6-8). Such progress in systemic treatments, as well as improvement in imaging detection, has both lead to an increased incidence of BM and changed the characteristics of corresponding patients.

In this context of more frequently stable and controlled systemic disease, BM management now represents an emerging area of interest in organ-specific metastasis research. Thus, evidence from randomised controlled trials make it possible to propose standard guidelines for local management, including the rationalized use of surgical resection, radiosurgery and adjuvant or exclusive whole-brain radiotherapy (9, 10). In addition, the concept of the blood brain barrier (BBB), which was thought to exclude most systemic therapeutics from the brain, thereby creating a putative sanctuary for metastatic tumors, is now increasingly being challenged and systemic therapeutics may have antitumor activity at the central nervous system (CNS) level (11).

The objective of this work was to review literature data in order to provide an overview of the most recent trends in epidemiology, clinical characteristics, therapeutic management and outcome of BM (excluding the specific topic of leptomenigeal disease).

Figure 1.
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Figure 1.

Incidence of brain metastases from 1986 to 2006 [according to Smedby et al. (14)] and MRI use [according to Nieder et al. (15)].

Global Incidence and Prevalence of BM

The estimated number of new cases of BM diagnosed each year in the USA is 170,000 (12) per year. The incidence of BM is hypothesized to have increased during the last 20 years (Figure 1). However, there are only two studies actually examining such time trends and their results are not very clear. Thus, Schouten et al. (13) used the Maastricht Cancer Registry to select patients that were at risk of developing BM (N=2724) from 1986 to 1995. This cohort was linked to the Neurooncology Registry of the University Hospital Maastricht. A diagnosis of BM was found in 232 patients (8.5%). The cumulative incidence of BM was 32.5% in patients with small cell lung cancer diagnosed in the period 1986-1990, and 26% for patients diagnosed in 1991-1995. Similar results were observed for breast cancer (6.5% versus 3.9% in 1986-1990 and 1991-1995 periods, respectively). The authors concluded that there was no evidence of an increasing incidence of BM in patients with breast and lung cancer. Conversely, a more recent survey by Smedby et al. (14) identified a cohort of 15,517 patients with BM in the Swedish National Patient Registry 2009. In this study, the annual age-adjusted incidence rate of hospitalization for BM doubled between 1987 and 2006, from 7 to 14 patients per 100,000. Primary malignancies behind the increase of BM were mainly lung cancer, irrespective of gender, and breast cancer in women. The discrepancy between these two studies could be attributed to three main parameters: a different definition of the population at risk when computing incidence estimates, a smaller sample size, as well as a shorter time period of observation in the study of Schouten et al., which was stopped in 1995, before the emergence of most of the changes detected in the study by Smedby et al.

Such an increase in BM incidence could be explained by the improvements in the quality of neuroimaging staging, particularly the more frequent use of Magnetic Resonance Imaging (MRI). To date, MRI is the most widely used examination for BM detection (64% today versus 14% 20 years ago) (15). Another potential explanation could be the global increase in cancer incidence with time. Indeed, in the period analyzed by the Swedish study, the incidence and prevalence of solid malignancies in the country increased from 490 to 530 per 100,000 individuals and from 3,236 to 4,130, respectively (14). In addition, for many cancer types, there has been a parallel improvement in prognosis due to an earlier detection of indolent tumors, as well as the use of more effective treatments. For example, improvement in the prognosis of breast cancer provides a basis for the substantial increase of patients with breast cancer being hospitalized for BM. The introduction in the adjuvant setting of trastuzumab, a targeted therapy with low presumed efficiency in the CNS, may have altered the natural history of patients with HER-2-positive breast cancer and unmasked CNS as a potential sanctuary site (5).

Incidence and Prevalence of BM According to the Primary Tumor

Several studies have also questioned the incidence and prevalence of BM according to the primary cancer (Figure 2). In a population-based study from the Metropolitan Detroit Cancer Surveillance System, Barnholtz et al. (16) collected data from 16,210 patients diagnosed with BM from various primary tumors between 1973 and 2001. The estimated global BM incidence was 9.6%, in descending order arising from lung (19.9%), melanoma (6.9%), renal (6.5%), breast (5.1%) and colorectal cancer (1.8%). In other studies, the incidence of BM ranged from 5% to 20% in breast cancer (17-20). Recent reports suggest that the incidence and prevalence of BM from breast cancer are increasing (21, 22). Pelletier et al. (23) evaluated the epidemiology and economic burden associated with BM from breast cancer. Data were obtained for 13,845 patients from the PharMetrics Patient-Centric Database between January 2002 and December 2004, showing an increase in prevalence of BM from breast cancer between 2002 (6.61%) and 2004 (11.78%). In another study by Nieder et al. (15) comparing two cohorts of patients with BM, the first treated between 2005 and 2009 and the second between 1983 and 1989, i.e. approximately 20 years earlier, BM from breast cancer cases were equally common (17% in both cohorts). The contemporary cohort contained slightly fewer patients with primary lung cancer (40% versus 52%) and slightly more melanoma (9% versus 5%), but differences was not significant. However, a significant higher number of patients with colorectal and kidney primaries (24% vs. 8%, p=0.002) as observed in the most recent cohort. A similar increase in prevalence of BM from colorectal cancer was found in another study (24). Again, these changes could be explained by a general improvement in detection, treatment and prognosis of these two cancer types (25-27). Of note, Kolomainen et al. (28) performed a study examining 3,690 patients with epithelial ovarian cancer and described an increase in incidence of BM from 0.3% between 1980 and 1994 to 1.3% between 1995 and 1999 (p<0.001). These data could also result from improvements in ovarian cancer management leading to a survival advantage, such as aggressive surgical resection and taxanes incorporation (29), and therefore an increased potential for cerebral dissemination.

Figure 2.
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Figure 2.

Partitioning of primary cancer in patients with brain metastases [according to Nieder et al. (15)].

Currently, the global prevalence of BM ranges from 8.5% to 9.6% (13, 16). These data are likely to underestimate the true BM prevalence, due to asymptomatic BM or symptomatic but ignored BM in a seriously ill patient with otherwise symptomatic advanced cancer. Although Pickren et al. (30) found a similar rate of BM in their study (8.7%), most other autopsy series reported higher rates: thus, Posner and Chernik (31) published data regarding 2,375 autopsies of patients with cancer and found 15% of patients with BM, while a US study from Rochester, Minnesota, demonstrated that 41% of the cancer patient population had BM. However, this study was not restricted to autopsy data (autopsy was carried out on only 70% of patients) (32). Moreover, autopsies of patients with melanoma revealed 40% of patients with BM (31) and autopsies of breast cancer patients found rates of BM ranging from 16% to 30% (33). Of note, these series of autopsy data are more than 20 years old. If the incidence of BM is increasing, the true prevalence may be even higher. However, new autopsy data are unlikely to be forthcoming because autopsy rates in the USA are now only about 5% (34, 35).

Patients' Characteristics

At the time of BM diagnosis, the performance status of patients was most frequently preserved, with a median Karnofsky Performans Status (KPS) at 70 and this characteristic has remained unchanged (3, 15, 36-38).

According to some US studies, the frequency of BM could be influenced by race (16, 39) since the incidence of BM in African-Americans was significantly higher compared to the white population for lung, melanoma and breast cancer, but was lower for renal cancer. However, these data may be impacted by social inequalities in healthcare access.

The median age at diagnosis ranged from 57 to 63 years (14, 16, 36-38, 40). This characteristic seems to have remained stable during the past 20 years. Age at diagnosis was influenced by primary cancer (14). The incidence of BM was highest for those diagnosed between the age of 40 to 49 years with primary lung cancer, 50 to 59 years with primary melanoma, renal or colorectal cancer and 20 to 39 years with breast cancer (41). It is noteworthy that there was no correlation between the age of peak incidence of BM and the age of peak incidence of the corresponding primary, especially for breast cancer. In fact, the higher frequency of BM in younger and/or African-American patients with breast cancer could be explained by the higher frequency in this population of triple-negative [ER, PR and HER2] tumors (42), in which an increased risk of CNS metastasis was demonstrated (43).

There were significantly more female than male patients in the contemporary cohort of patients with BM (15, 36), whereas male patients represented the majority of patients twenty years ago (2). This is likely to result from the increasing number of lung cancer cases diagnosed among women, as well as an increase in the incidence of BM in patients with breast cancer. Moreover, a distinct susceptibility in the development of BM according to gender could exist. Thus, in Barnholthz-Sloan et al. study (16), men had similar or higher (for melanoma) incidence of BM compared to women, whereas men with primary lung cancer had significantly less BM than women. Yawn et al. (44) looked at the rate of BM in patients diagnosed with primary lung or breast cancer between January 1988 and December 2001 in Olmsted County, Minnesota, and noted that women were twice as likely as men to have BM detected following primary lung cancer. However, these results remained controversial, and in another study (45), gender was not a predictive factor for brain progression in non-small cell lung carcinoma.

Disease Characteristics

The highest incidence for BM occurred for individuals diagnosed with advanced-stage disease (16, 36). This has remained unchanged with time. However, BM have become more often diagnosed as associated with multiple extracranial metastases [from 14 to 44% (15)] and the current proportion of patients with BM without extracranial disease has been decreasing [from 52% to 23% (15)] during the past 20 years (3, 37, 38). The number of patients with a single BM is also decreasing (3, 37, 40, 46), [from 63% to 29% (15)] whereas the proportion of patients with three or more BM has increased (38, 47) [from 17% to 36% (15)]. Simultaneous detection of BM and primary cancer was also more common [from 18% to 30% (15)] (38, 48-50) likely due to the more frequent use of brain imaging (including brain MRI) in the initial staging procedure (51). However, the median time interval from the diagnosis of the primary tumor to development of BM has increased significantly in the current decade (8 months versus 3 months) (3, 15). Such a time interval is actually dependent on, and strongly linked to, the primary cancer. Thus, the median time interval from primary to BM diagnosis ranged from 2.6 to 7 months (16, 52, 53) for lung cancer, but may reach 39 to 47 months for breast cancer (54-56).

There were significant changes in the distribution of prognostic classes. Fewer patients than twenty years ago are currently assigned to the most favorable (7% versus 19%) and most unfavorable (31% versus 44%) RPA prognostic classes (3, 15, 47). This could be the result of the already mentioned increase in concomitant extracranial metastases at BM diagnosis (since this directly participates in the RPA class allocation), even though systemic disease is increasingly being controlled.

Treatment

The use of surgical resection ranges between 16% and 18% (57-59). Its use has dramatically increased with time, with currently three times more surgical procedures being carried out for BM and a 79% relative increase in the annual number of surgical resections for BM (60). Stereotactic radiosurgery has also been developed and is now widely used (61). Currently, conventional surgery and/or stereotactic radiosurgery take part in the treatment of BM for 27% to 31% of patients (47). During the same time, the use of whole-brain radiotherapy (WBRT) did not decrease and is administered to two out of three patients (62-64). Finally, an increase in the total number of local procedures was observed (12, 62).

Another significant change has been in the more frequent use of systemic treatment (11, 55, 65). Systemic treatment and the number of lines administered before the BM onset was higher in the most recent patients. Currently, only 35% of patients have never received systemic treatment before the onset of BM, whereas this figure was 75% twenty years ago. Moreover, 13% of patients were found to receive three or more lines of systemic therapy before the diagnosis of BM. In addition, systemic treatments were more frequently administered after the onset of BM (45% versus 24%) (11, 15).

Accordingly, treatment of BM may increase financial costs. Thus, the total one-year cost of BM from breast cancer management was estimated at $99,899 in 2006 whereas it was $ 47,719 for the treatment of breast cancer without BM (23). Indeed, the diagnosis of BM was associated with more hospital stays, for a longer period, with more physician visits and pharmacy claims.

Survival

Nieder et al. (15) found that the median survival was only minimally improved in the most recent patients (from 3.2 to 3.9 months). In contrast, the one-year survival rate increased from 15% to 34% and some long-term survivors were observed. Survival was shown to be dependent on presentation of BM and on administered treatments. The median overall survival ranged from 8 to 13 months after surgery (57, 59, 66, 67), and from 8.5 (68) to 12.1 (69) months after stereotactic surgery. When focal procedures were not performed, the median survival was 3.2 to 3.6 months after WBRT alone (70) and 1.3 months with best supportive care only (12).

The impact of systemic therapies (chemotherapy and targeted therapy) is not really known at present (12, 55, 65, 71, 72). A retrospective study compared survival of patients with BM from breast cancer treated either with WBRT alone or WBRT followed by systemic treatment. The median survival was 3, 8 and 11 months for patients treated with WBRT alone, WBRT followed by chemotherapy and WBRT followed by systemic treatment including targeted therapies, respectively (73). These results support the use of systemic treatments in the management of BM from breast cancer.

Survival is also dependent on the nature of the primary cancer. Thus, the median survival for patients with BM ranges from 2.7 to 6.3 months (16, 74, 75) for lung cancer, from 5.1 (75, 76) to 6 months (24) for colorectal cancer and from 4.8 to 10 months for melanoma (16, 75, 77). Survival of patients with BM from breast cancer varied with clinic pathological and molecular subtypes. Thus, the median survival was estimated to be 2.9 months for inflammatory breast cancer, a rare and aggressive form of the disease (78). For the triple-negative subtype, the median survival was 4.9 months (79), whereas it ranged from 11.3 (80) to 26.3 months (40, 43, 81, 82) in HER2-overexpressing tumors receiving trastuzumab and from 19 to 24 months (81,83) for hormone receptor-positive tumors.

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Table I.

Time trends in clinical characteristics of brain metastases (BM).

Conclusion

BM was classically thought to appear in a context of uncontrolled systemic disease and was considered as a terminal phase of the disease. The usual treatment was surgery when possible, and/or WBRT. Systemic treatments were rarely used and were believed to have little or no efficacy. As shown in this review, important changes have recently been noted in the epidemiology of this disease (Table I). An increase in incidence and prevalence has been observed. On initial diagnosis, BM are more often multiple and occur later in the context of a more frequently controlled extracranial disease. Surgery, stereotactic radiosurgery and radiotherapy are still the mainstays of BM management, but the combined or sequential use of each of these approaches is increasingly selected based on expected probabilities of overall survival, local control and potential neurocognitive toxicities. In addition, the impact of systemic therapy is increasingly suggested. This emphasizes the need for developing specific clinical trials of therapy in BM, in order to increase both cerebral control and overall survival. Combined with the growing knowledge of the specific biology of BM, it is anticipated that these studies will result in significant progress in this devastating disease.

Footnotes

  • Presented, in part, at the 24th Annual Meeting of Eurocancer, June 2011, Paris, France

  • Competing Interests

    The Authors declare that they have no competing interest.

  • Received August 8, 2012.
  • Revision received October 8, 2012.
  • Accepted October 9, 2012.
  • Copyright© 2012 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved

References

  1. ↵
    1. Counsell CE,
    2. Collie DA,
    3. Grant R
    : Incidence of intracranial tumours in the Lothian region of Scotland, 1989-90. J Neurol Neurosurg Psychiatry 61: 143-150, 1996.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Walker AE,
    2. Robins M,
    3. Weinfeld FD
    : Epidemiology of brain tumors: The National Survey of intracranial neoplasms. Neurology 35: 219-226, 1985.
    OpenUrlAbstract/FREE Full Text
  3. ↵
    1. Gaspar L,
    2. Scott C,
    3. Rotman M,
    4. Asbell S,
    5. Phillips T,
    6. Wasserman T,
    7. McKenna WG,
    8. Byhardt R
    : Recursive partitioning analysis (RPA) of prognostic factors in three Radiation Therapy Oncology Group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37: 745-751, 1997.
    OpenUrlCrossRefPubMed
  4. ↵
    1. Slamon DJ,
    2. Clark GM,
    3. Wong SG,
    4. Levin WJ,
    5. Ullrich A,
    6. McGuire WL
    : Human breast cancer: Correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235: 177-182, 1987.
    OpenUrlAbstract/FREE Full Text
  5. ↵
    1. Slamon DJ,
    2. Leyland-Jones B,
    3. Shak S,
    4. Fuchs H,
    5. Paton V,
    6. Bajamonde A,
    7. Fleming T,
    8. Eiermann W,
    9. Wolter J,
    10. Pegram M,
    11. Baselga J,
    12. Norton L
    : Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 344: 783-792, 2001.
    OpenUrlCrossRefPubMed
  6. ↵
    1. Jemal A,
    2. Bray F,
    3. Center MM,
    4. Ferlay J,
    5. Ward E,
    6. Forman D
    : Global cancer statistics. CA Cancer J Clin 61: 69-90, 2011.
    OpenUrlCrossRefPubMed
    1. Kohler BA,
    2. Ward E,
    3. McCarthy BJ,
    4. Schymura MJ,
    5. Ries LA,
    6. Eheman C,
    7. Jemal A,
    8. Anderson RN,
    9. Ajani UA,
    10. Edwards BK
    : Annual report to the nation on the status of cancer, 1975-2007, featuring tumors of the brain and other nervous system. J Natl Cancer Inst 103: 714-736, 2011.
    OpenUrlAbstract/FREE Full Text
  7. ↵
    1. Siegel R,
    2. Ward E,
    3. Brawley O,
    4. Jemal A
    : Cancer statistics, 2011: The impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 61: 212-236, 2011.
    OpenUrlCrossRefPubMed
  8. ↵
    1. Kocher M,
    2. Soffietti R,
    3. Abacioglu U,
    4. Villa S,
    5. Fauchon F,
    6. Baumert BG,
    7. Fariselli L,
    8. Tzuk-Shina T,
    9. Kortmann RD,
    10. Carrie C,
    11. Ben HM,
    12. Kouri M,
    13. Valeinis E,
    14. van den Berge D,
    15. Collette S,
    16. Collette L,
    17. Mueller RP
    : Adjuvant whole-brain radiotherapy versus observation after radiosurgery or surgical resection of one to three cerebral metastases: results of the EORTC 22952-26001 study. J Clin Oncol 29: 134-141, 2011.
    OpenUrlAbstract/FREE Full Text
  9. ↵
    1. Patchell RA,
    2. Tibbs PA,
    3. Walsh JW,
    4. Dempsey RJ,
    5. Maruyama Y,
    6. Kryscio RJ,
    7. Markesbery WR,
    8. Macdonald JS,
    9. Young B
    : A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med 322: 494-500, 1990.
    OpenUrlCrossRefPubMed
  10. ↵
    1. Lin NU,
    2. Carey LA,
    3. Liu MC,
    4. Younger J,
    5. Come SE,
    6. Ewend M,
    7. Harris GJ,
    8. Bullitt E,
    9. Van den Abbeele AD,
    10. Henson JW,
    11. Li X,
    12. Gelman R,
    13. Burstein HJ,
    14. Kasparian E,
    15. Kirsch DG,
    16. Crawford A,
    17. Hochberg F,
    18. Winer EP
    : Phase II trial of lapatinib for brain metastases in patients with human epidermal growth factor receptor 2-positive breast cancer. J Clin Oncol 26: 1993-1999, 2008.
    OpenUrlAbstract/FREE Full Text
  11. ↵
    1. Langer CJ,
    2. Mehta MP
    : Current management of brain metastases, with a focus on systemic options. J Clin Oncol 23: 6207-6219, 2005.
    OpenUrlAbstract/FREE Full Text
  12. ↵
    1. Schouten LJ,
    2. Rutten J,
    3. Huveneers HA,
    4. Twijnstra A
    : Incidence of brain metastases in a cohort of patients with carcinoma of the breast, colon, kidney, and lung and melanoma. Cancer 94: 2698-2705, 2002.
    OpenUrlCrossRefPubMed
  13. ↵
    1. Smedby KE,
    2. Brandt L,
    3. Backlund ML,
    4. Blomqvist P
    : Brain metastases admissions in Sweden between 1987 and 2006. Br J Cancer 101: 1919-1924, 2009.
    OpenUrlCrossRefPubMed
  14. ↵
    1. Nieder C,
    2. Spanne O,
    3. Mehta MP,
    4. Grosu AL,
    5. Geinitz H
    : Presentation, patterns of care, and survival in patients with brain metastases: What has changed in the last 20 years? Cancer 2010.
  15. ↵
    1. Barnholtz-Sloan JS,
    2. Sloan AE,
    3. Davis FG,
    4. Vigneau FD,
    5. Lai P,
    6. Sawaya RE
    : Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol 22: 2865-2872, 2004.
    OpenUrlAbstract/FREE Full Text
  16. ↵
    1. Gril B,
    2. Evans L,
    3. Palmieri D,
    4. Steeg PS
    : Translational research in brain metastasis is identifying molecular pathways that may lead to the development of new therapeutic strategies. Eur J Cancer 46: 1204-1210, 2010.
    OpenUrlCrossRefPubMed
    1. Lin NU,
    2. Winer EP
    : Brain metastases: The HER2 paradigm. Clin Cancer Res 13: 1648-1655, 2007.
    OpenUrlAbstract/FREE Full Text
    1. Musolino A,
    2. Ciccolallo L,
    3. Panebianco M,
    4. Fontana E,
    5. Zanoni D,
    6. Bozzetti C,
    7. Michiara M,
    8. Silini EM,
    9. Ardizzoni A
    : Multifactorial central nervous system recurrence susceptibility in patients with HER2-positive breast cancer: epidemiological and clinical data from a population-based cancer registry study. Cancer 117(9): 1837-1846, 2010.
    OpenUrlPubMed
  17. ↵
    1. Nathoo N,
    2. Toms SA,
    3. Barnett GH
    : Metastases to the brain: Current management perspectives. Expert Rev Neurother 4: 633-640, 2004.
    OpenUrlPubMed
  18. ↵
    1. Pestalozzi BC,
    2. Zahrieh D,
    3. Price KN,
    4. Holmberg SB,
    5. Lindtner J,
    6. Collins J,
    7. Crivellari D,
    8. Fey MF,
    9. Murray E,
    10. Pagani O,
    11. Simoncini E,
    12. Castiglione-Gertsch M,
    13. Gelber RD,
    14. Coates AS,
    15. Goldhirsch A
    : Identifying breast cancer patients at risk for Central Nervous System (CNS) metastases in trials of the International Breast Cancer Study Group (IBCSG). Ann Oncol 17: 935-944, 2006.
    OpenUrlAbstract/FREE Full Text
  19. ↵
    1. Frisk G,
    2. Svensson T,
    3. Backlund LM,
    4. Lidbrink E,
    5. Blomqvist P,
    6. Smedby KE
    : Incidence and time trends of brain metastases admissions among breast cancer patients in Sweden. Br J Cancer 106: 1850-1853, 2012.
    OpenUrlCrossRefPubMed
  20. ↵
    1. Pelletier EM,
    2. Shim B,
    3. Goodman S,
    4. Amonkar MM
    : Epidemiology and economic burden of brain metastases among patients with primary breast cancer: Results from a US claims data analysis. Breast Cancer Res Treat 108: 297-305, 2008.
    OpenUrlPubMed
  21. ↵
    1. Nieder C,
    2. Pawinski A,
    3. Balteskard L
    : Colorectal cancer metastatic to the brain: Time trends in presentation and outcome. Oncology 76: 369-374, 2009.
    OpenUrlPubMed
  22. ↵
    1. Hurwitz H,
    2. Fehrenbacher L,
    3. Novotny W,
    4. Cartwright T,
    5. Hainsworth J,
    6. Heim W,
    7. Berlin J,
    8. Baron A,
    9. Griffing S,
    10. Holmgren E,
    11. Ferrara N,
    12. Fyfe G,
    13. Rogers B,
    14. Ross R,
    15. Kabbinavar F
    : Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350: 2335-2342, 2004.
    OpenUrlCrossRefPubMed
    1. Karapetis CS,
    2. Khambata-Ford S,
    3. Jonker DJ,
    4. O'Callaghan CJ,
    5. Tu D,
    6. Tebbutt NC,
    7. Simes RJ,
    8. Chalchal H,
    9. Shapiro JD,
    10. Robitaille S,
    11. Price TJ,
    12. Shepherd L,
    13. Au HJ,
    14. Langer C,
    15. Moore MJ,
    16. Zalcberg JR
    : K-RAS mutations and benefit from cetuximab in advanced colorectal cancer. N Engl J Med 359: 1757-1765, 2008.
    OpenUrlCrossRefPubMed
  23. ↵
    1. Motzer RJ,
    2. Hutson TE,
    3. Tomczak P,
    4. Michaelson MD,
    5. Bukowski RM,
    6. Rixe O,
    7. Oudard S,
    8. Negrier S,
    9. Szczylik C,
    10. Kim ST,
    11. Chen I,
    12. Bycott PW,
    13. Baum CM,
    14. Figlin RA
    : Sunitinib versus interferon alpha in metastatic renal-cell carcinoma. N Engl J Med 356: 115-124, 2007.
    OpenUrlCrossRefPubMed
  24. ↵
    1. Kolomainen DF,
    2. Larkin JM,
    3. Badran M,
    4. A'Hern RP,
    5. King DM,
    6. Fisher C,
    7. Bridges JE,
    8. Blake PR,
    9. Barton DP,
    10. Shepherd JH,
    11. Kaye SB,
    12. Gore ME
    : Epithelial ovarian cancer metastasizing to the brain: A late manifestation of the disease with an increasing incidence. J Clin Oncol 20: 982-986, 2002.
    OpenUrlAbstract/FREE Full Text
  25. ↵
    1. McGuire WP,
    2. Hoskins WJ,
    3. Brady MF,
    4. Kucera PR,
    5. Partridge EE,
    6. Look KY,
    7. Clarke-Pearson DL,
    8. Davidson M
    : Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer. N Engl J Med 334: 1-6, 1996.
    OpenUrlCrossRefPubMed
  26. ↵
    1. Pickren JW,
    2. Lopez G,
    3. Tsukada Y,
    4. Lane WW
    : Brain metastases: An autopsy study. Cancer Treat Symp 2: 295-313, 1983.
    OpenUrl
  27. ↵
    1. Posner JB,
    2. Chernik NL
    : Intracranial metastases from systemic cancer. Adv Neurol 19: 579-592, 1978.
    OpenUrlPubMed
  28. ↵
    1. Percy AK
    : Neoplasms of the central nervous system: Epidemiologic considerations. Neurology 20: 398-399, 1970.
    OpenUrlFREE Full Text
  29. ↵
    1. Tsukada Y,
    2. Fouad A,
    3. Pickren JW,
    4. Lane WW
    : Central nervous system metastasis from breast carcinoma. Autopsy study. Cancer 52: 2349-2354, 1983.
    OpenUrlCrossRefPubMed
  30. ↵
    1. Fox BD,
    2. Cheung VJ,
    3. Patel AJ,
    4. Suki D,
    5. Rao G
    : Epidemiology of metastatic brain tumors. Neurosurg Clin N Am 22: 1-6, v, 2011.
    OpenUrlCrossRefPubMed
  31. ↵
    1. Gavrilovic IT,
    2. Posner JB
    : Brain metastases: Epidemiology and pathophysiology. J Neurooncol 75: 5-14, 2005.
    OpenUrlCrossRefPubMed
  32. ↵
    1. Nieder C,
    2. Marienhagen K,
    3. Geinitz H,
    4. Molls M
    : Validation of the graded prognostic assessment index for patients with brain metastases. Acta Oncol 48: 457-459, 2009.
    OpenUrlPubMed
  33. ↵
    1. Sperduto PW,
    2. Berkey B,
    3. Gaspar LE,
    4. Mehta M,
    5. Curran W
    : A new prognostic index and comparison to three other indices for patients with brain metastases: An analysis of 1,960 patients in the RTOG database. Int J Radiat Oncol Biol Phys 70: 510-514, 2008.
    OpenUrlCrossRefPubMed
  34. ↵
    1. Villa S,
    2. Weber DC,
    3. Moretones C,
    4. Manes A,
    5. Combescure C,
    6. Jove J,
    7. Puyalto P,
    8. Cuadras P,
    9. Bruna J,
    10. Verger E,
    11. Balana C,
    12. Graus F
    : Validation of the new Graded Prognostic Assessment scale for brain metastases: A multicenter prospective study. Radiat Oncol 6: 23-31, 2011.
    OpenUrlPubMed
  35. ↵
    1. Schootman M,
    2. Jeffe DB,
    3. Gillanders WE,
    4. Aft R
    : Racial disparities in the development of breast cancer metastases among older women: A multilevel study. Cancer 115: 731-740, 2009.
    OpenUrlCrossRefPubMed
  36. ↵
    1. Eichler AF,
    2. Kuter I,
    3. Ryan P,
    4. Schapira L,
    5. Younger J,
    6. Henson JW
    : Survival in patients with brain metastases from breast cancer: The importance of HER-2 status. Cancer 112: 2359-2367, 2008.
    OpenUrlCrossRefPubMed
  37. ↵
    1. Lin NU,
    2. Bellon JR,
    3. Winer EP
    : CNS metastases in breast cancer. J Clin Oncol 22: 3608-3617, 2004.
    OpenUrlAbstract/FREE Full Text
  38. ↵
    1. Anders CK,
    2. Deal AM,
    3. Miller CR,
    4. Khorram C,
    5. Meng H,
    6. Burrows E,
    7. Livasy C,
    8. Fritchie K,
    9. Ewend MG,
    10. Perou CM,
    11. Carey LA
    : The prognostic contribution of clinical breast cancer subtype, age, and race among patients with breast cancer brain metastases. Cancer 117(8): 1602-1611, 2010.
    OpenUrlPubMed
  39. ↵
    1. Heitz F,
    2. Harter P,
    3. Lueck HJ,
    4. Fissler-Eckhoff A,
    5. Lorenz-Salehi F,
    6. Scheil-Bertram S,
    7. Traut A,
    8. du BA
    : Triple-negative and HER2-overexpressing breast cancers exhibit an elevated risk and an earlier occurrence of cerebral metastases. Eur J Cancer 45: 2792-2798, 2009.
    OpenUrlCrossRefPubMed
  40. ↵
    1. Yawn BP,
    2. Wollan PC,
    3. Schroeder C,
    4. Gazzuola L,
    5. Mehta M
    : Temporal and gender-related trends in brain metastases from lung and breast cancer. Minn Med 86: 32-37, 2003.
    OpenUrlPubMed
  41. ↵
    1. Bajard A,
    2. Westeel V,
    3. Dubiez A,
    4. Jacoulet P,
    5. Pernet D,
    6. Dalphin JC,
    7. Depierre A
    : Multivariate analysis of factors predictive of brain metastases in localised non-small cell lung carcinoma. Lung Cancer 45: 317-323, 2004.
    OpenUrlCrossRefPubMed
  42. ↵
    1. Delattre JY,
    2. Krol G,
    3. Thaler HT,
    4. Posner JB
    : Distribution of brain metastases. Arch Neurol 45: 741-744, 1988.
    OpenUrlCrossRefPubMed
  43. ↵
    1. Fabi A,
    2. Felici A,
    3. Metro G,
    4. Mirri A,
    5. Bria E,
    6. Telera S,
    7. Moscetti L,
    8. Russillo M,
    9. Lanzetta G,
    10. Mansueto G,
    11. Pace A,
    12. Maschio M,
    13. Vidiri A,
    14. Sperduti I,
    15. Cognetti F,
    16. Carapella CM
    : Brain metastases from solid tumors: disease outcome according to type of treatment and therapeutic resources of the treating center. J Exp Clin Cancer Res 30: 10-17, 2011.
    OpenUrlPubMed
  44. ↵
    1. Heon S,
    2. Yeap BY,
    3. Britt GJ,
    4. Costa DB,
    5. Rabin MS,
    6. Jackman DM,
    7. Johnson BE
    : Development of central nervous system metastases in patients with advanced non-small cell lung cancer and somatic EGFR mutations treated with gefitinib or erlotinib. Clin Cancer Res 16: 5873-5882, 2010.
    OpenUrlAbstract/FREE Full Text
    1. Ogawa S,
    2. Horio Y,
    3. Yatabe Y,
    4. Fukui T,
    5. Ito S,
    6. Hasegawa Y,
    7. Mitsudomi T,
    8. Hida T
    : Patterns of recurrence and outcome in patients with surgically resected small cell lung cancer. Int J Clin Oncol 17: 218-224, 2011.
    OpenUrlPubMed
  45. ↵
    1. Vuong DA,
    2. Rades D,
    3. Vo SQ,
    4. Busse R
    : Extracranial metastatic patterns on occurrence of brain metastases. J Neurooncol 105: 83-90, 2011.
    OpenUrlPubMed
  46. ↵
    1. Shi AA,
    2. Digumarthy SR,
    3. Temel JS,
    4. Halpern EF,
    5. Kuester LB,
    6. Aquino SL
    : Does initial staging or tumor histology better identify asymptomatic brain metastases in patients with non-small cell lung cancer? J Thorac Oncol 1: 205-210, 2006.
    OpenUrlPubMed
  47. ↵
    1. Sheehan J,
    2. Kondziolka D,
    3. Flickinger J,
    4. Lunsford LD
    : Radiosurgery for patients with recurrent small cell lung carcinoma metastatic to the brain: Outcomes and prognostic factors. J Neurosurg 102(Suppl): 247-254, 2005.
    OpenUrlCrossRefPubMed
  48. ↵
    1. Sheehan JP,
    2. Sun MH,
    3. Kondziolka D,
    4. Flickinger J,
    5. Lunsford LD
    : Radiosurgery for non-small cell lung carcinoma metastatic to the brain: Long-term outcomes and prognostic factors influencing patient survival time and local tumor control. J Neurosurg 97: 1276-1281, 2002.
    OpenUrlCrossRefPubMed
  49. ↵
    1. Le SR,
    2. Massard C,
    3. Mouret-Fourme E,
    4. Guinebretierre JM,
    5. Cohen-Solal C,
    6. De LB,
    7. Moisson P,
    8. Breton-Callu C,
    9. Gardner M,
    10. Goupil A,
    11. Renody N,
    12. Floiras JL,
    13. Labib A
    : Brain metastases from breast carcinoma: Validation of the radiation therapy oncology group recursive partitioning analysis classification and proposition of a new prognostic score. Int J Radiat Oncol Biol Phys 69: 839-845, 2007.
    OpenUrlCrossRefPubMed
  50. ↵
    1. Niwinska A,
    2. Murawska M,
    3. Pogoda K
    : Breast cancer subtypes and response to systemic treatment after whole-brain radiotherapy in patients with brain metastases. Cancer 116: 4238-4247, 2010.
    OpenUrlPubMed
  51. ↵
    1. Niwinska A,
    2. Murawska M,
    3. Pogoda K
    : Breast cancer brain metastases: Differences in survival depending on biological subtype, RPA RTOG prognostic class and systemic treatment after whole-brain radiotherapy (WBRT). Ann Oncol 21: 942-948, 2010.
    OpenUrlAbstract/FREE Full Text
  52. ↵
    1. Andrews DW
    : Should surgery followed by whole-brain radiation therapy be the standard treatment for single brain metastasis? Nat Clin Pract Oncol 5: 572-573, 2008.
    OpenUrlPubMed
    1. Kalkanis SN,
    2. Kondziolka D,
    3. Gaspar LE,
    4. Burri SH,
    5. Asher AL,
    6. Cobbs CS,
    7. Ammirati M,
    8. Robinson PD,
    9. Andrews DW,
    10. Loeffler JS,
    11. McDermott M,
    12. Mehta MP,
    13. Mikkelsen T,
    14. Olson JJ,
    15. Paleologos NA,
    16. Patchell RA,
    17. Ryken TC,
    18. Linskey ME
    : The role of surgical resection in the management of newly diagnosed brain metastases: A systematic review and evidence-based clinical practice guideline. J Neurooncol 96: 33-43, 2010.
    OpenUrlCrossRefPubMed
  53. ↵
    1. Paek SH,
    2. Audu PB,
    3. Sperling MR,
    4. Cho J,
    5. Andrews DW
    : Reevaluation of surgery for the treatment of brain metastases: review of 208 patients with single or multiple brain metastases treated at one institution with modern neurosurgical techniques. Neurosurgery 56: 1021-1034, 2005.
    OpenUrlPubMed
  54. ↵
    1. Barker FG
    : Craniotomy for the resection of metastatic brain tumors in the U.S., 1988-2000: Decreasing mortality and the effect of provider caseload. Cancer 100: 999-1007, 2004.
    OpenUrlPubMed
  55. ↵
    1. Patchell RA,
    2. Regine WF,
    3. Loeffler JS,
    4. Sawaya R,
    5. Andrews DW,
    6. Chin LS
    : Radiosurgery plus whole-brain radiation therapy for brain metastases. JAMA 296: 2089-2090, 2006.
    OpenUrlCrossRefPubMed
  56. ↵
    1. Andrews DW,
    2. Scott CB,
    3. Sperduto PW,
    4. Flanders AE,
    5. Gaspar LE,
    6. Schell MC,
    7. Werner-Wasik M,
    8. Demas W,
    9. Ryu J,
    10. Bahary JP,
    11. Souhami L,
    12. Rotman M,
    13. Mehta MP,
    14. Curran WJ Jr..
    : 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 363: 1665-1672, 2004.
    OpenUrlCrossRefPubMed
    1. Davey P,
    2. Hoegler D,
    3. Ennis M,
    4. Smith J
    : A phase III study of accelerated versus conventional hypofractionated whole-brain irradiation in patients of good performance status with brain metastases not suitable for surgical excision. Radiother Oncol 88: 173-176, 2008.
    OpenUrlCrossRefPubMed
  57. ↵
    1. Gaspar LE,
    2. Mehta MP,
    3. Patchell RA,
    4. Burri SH,
    5. Robinson PD,
    6. Morris RE,
    7. Ammirati M,
    8. Andrews DW,
    9. Asher AL,
    10. Cobbs CS,
    11. Kondziolka D,
    12. Linskey ME,
    13. Loeffler JS,
    14. McDermott M,
    15. Mikkelsen T,
    16. Olson JJ,
    17. Paleologos NA,
    18. Ryken TC,
    19. Kalkanis SN
    : The role of whole-brain radiation therapy in the management of newly diagnosed brain metastases: A systematic review and evidence-based clinical practice guideline. J Neurooncol 96: 17-32, 2010.
    OpenUrlCrossRefPubMed
  58. ↵
    1. Patel RR,
    2. Mehta MP
    : Targeted therapy for brain metastases: Improving the therapeutic ratio. Clin Cancer Res 13: 1675-1683, 2007.
    OpenUrlAbstract/FREE Full Text
  59. ↵
    1. Andrews DW
    : Current neurosurgical management of brain metastases. Semin Oncol 35: 100-107, 2008.
    OpenUrlCrossRefPubMed
  60. ↵
    1. Andrews RJ,
    2. Gluck DS,
    3. Konchingeri RH
    : Surgical resection of brain metastases from lung cancer. Acta Neurochir (Wien) 138: 382-389, 1996.
    OpenUrlCrossRefPubMed
  61. ↵
    1. Frazier JL,
    2. Batra S,
    3. Kapor S,
    4. Vellimana A,
    5. Gandhi R,
    6. Carson KA,
    7. Shokek O,
    8. Lim M,
    9. Kleinberg L,
    10. Rigamonti D
    : Stereotactic radiosurgery in the management of brain metastases: An institutional retrospective analysis of survival. Int J Radiat Oncol Biol Phys 76: 1486-1492, 2010.
    OpenUrlPubMed
  62. ↵
    1. Golden DW,
    2. Lamborn KR,
    3. McDermott MW,
    4. Kunwar S,
    5. Wara WM,
    6. Nakamura JL,
    7. Sneed PK
    : Prognostic factors and grading systems for overall survival in patients treated with radiosurgery for brain metastases: variation by primary site. J Neurosurg 109(Suppl): 77-86, 2008.
    OpenUrlCrossRefPubMed
  63. ↵
    1. Murray KJ,
    2. Scott C,
    3. Greenberg HM,
    4. Emami B,
    5. Seider M,
    6. Vora NL,
    7. Olson C,
    8. Whitton A,
    9. Movsas B,
    10. Curran W
    : A randomized phase III study of accelerated hyperfractionation versus standard in patients with unresected brain metastases: A report of the Radiation Therapy Oncology Group (RTOG) 9104. Int J Radiat Oncol Biol Phys 39: 571-574, 1997.
    OpenUrlCrossRefPubMed
  64. ↵
    1. Guerrieri M,
    2. Wong K,
    3. Ryan G,
    4. Millward M,
    5. Quong G,
    6. Ball DL
    : A randomised phase III study of palliative radiation with concomitant carboplatin for brain metastases from non-small cell carcinoma of the lung. Lung Cancer 46: 107-111, 2004.
    OpenUrlCrossRefPubMed
  65. ↵
    1. Mehta MP,
    2. Paleologos NA,
    3. Mikkelsen T,
    4. Robinson PD,
    5. Ammirati M,
    6. Andrews DW,
    7. Asher AL,
    8. Burri SH,
    9. Cobbs CS,
    10. Gaspar LE,
    11. Kondziolka D,
    12. Linskey ME,
    13. Loeffler JS,
    14. McDermott M,
    15. Olson JJ,
    16. Patchell RA,
    17. Ryken TC,
    18. Kalkanis SN
    : The role of chemotherapy in the management of newly diagnosed brain metastases: A systematic review and evidence-based clinical practice guideline. J Neurooncol 96: 71-83, 2010.
    OpenUrlCrossRefPubMed
  66. ↵
    1. Melisko ME,
    2. Moore DH,
    3. Sneed PK,
    4. De FJ,
    5. Rugo HS
    : Brain metastases in breast cancer: Clinical and pathologic characteristics associated with improvements in survival. J Neurooncol 88: 359-365, 2008.
    OpenUrlCrossRefPubMed
  67. ↵
    1. Pesce GA,
    2. Klingbiel D,
    3. Ribi K,
    4. Zouhair A,
    5. von MR,
    6. Schlaeppi M,
    7. Caspar CB,
    8. Fischer N,
    9. Anchisi S,
    10. Peters S,
    11. Cathomas R,
    12. Bernhard J,
    13. Kotrubczik NM,
    14. D'Addario G,
    15. Pilop C,
    16. Weber DC,
    17. Bodis S,
    18. Pless M,
    19. Mayer M,
    20. Stupp R
    : Outcome, quality of life and cognitive function of patients with brain metastases from non-small cell lung cancer treated with whole-brain radiotherapy combined with gefitinib or temozolomide. A randomised phase II trial of the Swiss Group for Clinical Cancer Research (SAKK 70/03). Eur J Cancer 48: 377-384, 2011.
    OpenUrlPubMed
  68. ↵
    1. Sperduto PW,
    2. Kased N,
    3. Roberge D,
    4. Xu Z,
    5. Shanley R,
    6. Luo X,
    7. Sneed PK,
    8. Chao ST,
    9. Weil RJ,
    10. Suh J,
    11. Bhatt A,
    12. Jensen AW,
    13. Brown PD,
    14. Shih HA,
    15. Kirkpatrick J,
    16. Gaspar LE,
    17. Fiveash JB,
    18. Chiang V,
    19. Knisely JP,
    20. Sperduto CM,
    21. Lin N,
    22. Mehta M
    : Summary report on the Graded Prognostic Assessment: An accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 30: 419-425, 2012.
    OpenUrlAbstract/FREE Full Text
  69. ↵
    1. Kruser TJ,
    2. Chao ST,
    3. Elson P,
    4. Barnett GH,
    5. Vogelbaum MA,
    6. Angelov L,
    7. Weil RJ,
    8. Pelley R,
    9. Suh JH
    : Multidisciplinary management of colorectal brain metastases: A retrospective study. Cancer 113: 158-165, 2008.
    OpenUrlPubMed
  70. ↵
    1. Devito N,
    2. Yu M,
    3. Chen R,
    4. Pan E
    : Retrospective study of patients with brain metastases from melanoma receiving concurrent whole-brain radiation and temozolomide. Anticancer Res 31: 4537-4543, 2011.
    OpenUrlAbstract/FREE Full Text
  71. ↵
    1. Dawood S,
    2. Broglio K,
    3. Esteva FJ,
    4. Yang W,
    5. Kau SW,
    6. Islam R,
    7. Albarracin C,
    8. Yu TK,
    9. Green M,
    10. Hortobagyi GN,
    11. Gonzalez-Angulo AM
    : Survival among women with triple receptor-negative breast cancer and brain metastases. Ann Oncol 20: 621-627, 2009.
    OpenUrlAbstract/FREE Full Text
  72. ↵
    1. Lin NU,
    2. Claus E,
    3. Sohl J,
    4. Razzak AR,
    5. Arnaout A,
    6. Winer EP
    : Sites of distant recurrence and clinical outcomes in patients with metastatic triple-negative breast cancer: High incidence of central nervous system metastases. Cancer 113: 2638-2645, 2008.
    OpenUrlCrossRefPubMed
  73. ↵
    1. Church DN,
    2. Modgil R,
    3. Guglani S,
    4. Bahl A,
    5. Hopkins K,
    6. Braybrooke JP,
    7. Blair P,
    8. Price CG
    : Extended survival in women with brain metastases from HER2-overexpressing breast cancer. Am J Clin Oncol 31: 250-254, 2008.
    OpenUrlCrossRefPubMed
  74. ↵
    1. Heitz F,
    2. Rochon J,
    3. Harter P,
    4. Lueck HJ,
    5. Fisseler-Eckhoff A,
    6. Barinoff J,
    7. Traut A,
    8. Lorenz-Salehi F,
    9. du BA
    : Cerebral metastases in metastatic breast cancer: disease-specific risk factors and survival. Ann Oncol 22: 1571-1581, 2011.
    OpenUrlAbstract/FREE Full Text
  75. ↵
    1. Lai R,
    2. Dang CT,
    3. Malkin MG,
    4. Abrey LE
    : The risk of central nervous system metastases after trastuzumab therapy in patients with breast carcinoma. Cancer 101: 810-816, 2004.
    OpenUrlCrossRefPubMed
  76. ↵
    1. Miller KD,
    2. Weathers T,
    3. Haney LG,
    4. Timmerman R,
    5. Dickler M,
    6. Shen J,
    7. Sledge GW Jr..
    : Occult central nervous system involvement in patients with metastatic breast cancer: prevalence, predictive factors and impact on overall survival. Ann Oncol 14: 1072-1077, 2003.
    OpenUrlAbstract/FREE Full Text
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Anticancer Research: 32 (11)
Anticancer Research
Vol. 32, Issue 11
November 2012
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Recent Trends in Epidemiology of Brain Metastases: An Overview
EMELINE TABOURET, OLIVIER CHINOT, PHILIPPE METELLUS, AGNÈS TALLET, PATRICE VIENS, ANTHONY GONÇALVES
Anticancer Research Nov 2012, 32 (11) 4655-4662;

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Recent Trends in Epidemiology of Brain Metastases: An Overview
EMELINE TABOURET, OLIVIER CHINOT, PHILIPPE METELLUS, AGNÈS TALLET, PATRICE VIENS, ANTHONY GONÇALVES
Anticancer Research Nov 2012, 32 (11) 4655-4662;
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  • Global DNA demethylation as an epigenetic marker of human brain metastases
  • Identification of brain metastasis genes and therapeutic evaluation of histone deacetylase inhibitors in a clinically relevant model of breast cancer brain metastasis
  • Radiosurgery for Brain Metastases: Changing Practice Patterns and Disparities in the United States
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Keywords

  • brain metastases
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  • Lung cancer
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