for those facing whole brain radiation 4 brain mets--Antiepileptic drug use improves

[Lani]

overall survival in breast cancer patients with brain metastases in the setting of whole brain radiotherapy.

Don't freak out at the dire numbers--once again, her2+ brain mets had far better prognosis. The stats may also be scewed by the fact that those with few/small brain mets are more likely to undergo SRS (cyberknife or gammaknife) tha WBR



Radiother Oncol. 2015 Oct 16. pii: S0167-8140(15)00551-4. doi: 10.1016/j.radonc.2015.10.009.

Antiepileptic drug use improves overall survival in breast cancer patients with brain metastases in the setting of whole brain radiotherapy.
Reddy JP1, Dawood S2, Mitchell M1, Debeb BG1, Bloom E1, Gonzalez-Angulo AM3, Sulman EP1, Buchholz TA1, Woodward WA4.
Author information
Abstract
BACKGROUND AND PURPOSE:
There is mounting evidence that histone deacetylase (HDAC) inhibitors, e.g. valproic acid (VPA), synergize with radiation to improve outcomes in several cancers. This study was conducted to ascertain whether VPA affected outcomes in breast cancer patients with brain metastases treated with whole brain radiotherapy (WBRT).
MATERIALS AND METHODS:
Records from 253 breast cancer patients with brain metastases treated with WBRT were reviewed. Data regarding use of all antiepileptic drugs (AEDs) were extracted. Kaplan-Meier survival times were calculated using the date of brain involvement as time zero. Cox proportional hazard models were used to determine the association between patient and tumor characteristics and overall survival (OS).
RESULTS:
Median OS for the entire patient cohort was 6months. Patients receiving VPA (n=20) had a median OS of 11months versus 5months for those not receiving VPA (p=0.028). Median OS was 9months for patients taking any AED (n=101) versus 4months for those not taking AEDs (p=0.0003). On multivariate analysis both VPA and AED use were associated with improved OS (HR 0.61, p=0.0419; HR 0.59, p=0.0002, respectively).
CONCLUSIONS:
This study suggests the use of AEDs, including VPA, is associated with improved OS in breast cancer patients with brain metastases following WBRT.
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
KEYWORDS:
Anticonvulsants; Antiepileptic drugs; Brain metastases; Breast cancer; Radiation; Valproic acid
PMID: 26482599 [PubMed - as supplied by publisher]