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Radiation treatment patterns for breast cancer brain metastases: an NCDB analysis.

Overview

Authors: Thamilini Pathmarajah1, Yevgeniya Gokun2, Nicole Williams3, Gina M. Sizemore1, Heather Lefebvre3, Margaret E. Gatti-Mays3, Brandon Slover2, Sierra Daniel1, Tanun Jitwatcharakomol1, Jacob Eckstein1, Therese Andraos1, Rebekah Young1, John Grecula1, Raju Raval1, Raj Singh1, Simeng Zhu1, Dukajin Blakaj1, Arnab Chakravarti1, Joshua Palmer1, Daniel Stover3, Sachin R. Jhawar1, Sasha Beyer1
  1. Department of Radiation Oncology, The Ohio State University Comprehensive Cancer Center,Columbus, OH USA
  2. Center for Biostatistics, The Ohio State University Wexner Medical Center,Columbus, OH USA
  3. Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center,Columbus, OH USA
Institutions: The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (United States); The Ohio State University Wexner Medical Center (United States)
Journal: Breast cancer research and treatment, volume 217, issue 2, article 26
Dates: received 7 January 2026; accepted 23 March 2026; published online 22 April 2026; in print 2026
Type: Research article · Language: English
License: CC BY
Identifiers: DOI 10.1007/s10549-026-07955-z · PMID 42018017 · PMCID PMC13102853 · OpenAlex W7155226079
Open access: hybrid, a free copy (OpenAlex)
Status: code on request
Categories: human (organism), other condition (population), clinical / translational (subfield)
Methods: Statistics, Machine learning
Keywords: Breast cancer, Brain metastases, Stereotactic radiation, Whole brain radiation, Metastatic breast cancer
MeSH: Brain Neoplasms*, Breast Neoplasms*, Cranial Irradiation*, Radiosurgery*, Adult, Aged, Databases, Factual, Female, Humans, Middle Aged, Treatment Outcome (* major topic)
Topic: Brain Metastases and Treatment (Pulmonary and Respiratory Medicine, Medicine), according to OpenAlex
Citations: not cited yet (Europe PMC); 25 references in the paper

Abstract

Purpose: Breast cancer (BC) brain metastases (BM) treatment involves radiotherapy (RT), surgery, and CNS-penetrating systemic therapies. This study evaluated treatment patterns in brain RT and corresponding survival outcomes among patients with BC BM using the National Cancer Database (NCDB).

Methods: Patients diagnosed with BC BM between 2010 and 2021 were identified. RT was categorized as whole brain (WBRT) vs. stereotactic (SRT). We fitted Overlap Propensity Score Weighting (OPSW) Cox models to account for confounders affecting OS. Variables included age, race, ethnicity, Charlson–Deyo score, insurance, molecular subtype, facility type, and systemic therapy.

Results: Of 8909 patients with BC BM, 43.4% received brain RT (74.1% WBRT, 25.9% SRT). Patients that are African American, lower income, urban, triple-negative, or at community facilities were more likely to receive WBRT over SRT (p < 0.05). Median OS for the entire cohort was 10.9 months (95% CI 10.4–11.5). Systemic therapy alone (HR 0.40, 95% CI 0.36–0.43) or combined with RT (HR 0.38, 95% CI 0.35–0.42) improved OS; however RT alone did not improve survival on MVA (HR 0.96 (95% CI 0.91–1.02). Among RT recipients, SRT was associated with improved OS vs. WBRT (HR 0.76, 95% CI 0.69–0.83). Older age, comorbidities, lack of insurance, community facilities, and aggressive subtypes were associated with worse OS.

Conclusions: Treatment patterns, particularly access to SRT, differ among BC BM patients therefore highlighting the need for strategies to promote equitable implementation of evidence-based guidelines. More prospective trials are also needed to establish evidence-based treatment standards for BC BM.

Supplementary Information: The online version contains supplementary material available at 10.1007/s10549-026-07955-z.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

The paper says that its authors' code is available on request: it was not published with the paper, so there is nothing to verify.

Tracing map

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Data

No dataset and no data link were found in the paper.

Data availability

Data are available in the National Cancer Database (NCDB) upon request at https://www.facs.org/quality-programs/cancer-programs/national-cancer-database/.

Reproduced under the paper's license (CC BY), from the paper cited above.

Versions

The history of this record: each version stored by the harvester or made by a correction of its authors or of the maintainers of its code, and what changed in its facts. The texts of the paper (its abstract, its availability statements) are not part of it; versions that changed only those are not listed.

Version 1, 29 September 2026: the first record

Recorded: type, language, journal, volume, issue, pages, dates, 22 authors, 5 keywords, 11 MeSH terms, 23 references.

Cite

This paper

Pathmarajah, T., Gokun, Y., Williams, N., Sizemore, G. M., Lefebvre, H., Gatti-Mays, M. E., Slover, B., Daniel, S., Jitwatcharakomol, T., Eckstein, J., Andraos, T., Young, R., Grecula, J., Raval, R., Singh, R., Zhu, S., Blakaj, D., Chakravarti, A., Palmer, J., . . . Beyer, S. (2026). Radiation treatment patterns for breast cancer brain metastases: an NCDB analysis. Breast cancer research and treatment, 217(2), 26. https://doi.org/10.1007/s10549-026-07955-z

BibTeX

@article{pathmarajah2026radiation,
author = {Pathmarajah, Thamilini and Gokun, Yevgeniya and Williams, Nicole and Sizemore, Gina M. and Lefebvre, Heather and Gatti-Mays, Margaret E. and Slover, Brandon and Daniel, Sierra and Jitwatcharakomol, Tanun and Eckstein, Jacob and Andraos, Therese and Young, Rebekah and Grecula, John and Raval, Raju and Singh, Raj and Zhu, Simeng and Blakaj, Dukajin and Chakravarti, Arnab and Palmer, Joshua and Stover, Daniel and Jhawar, Sachin R. and Beyer, Sasha},
title = {{Radiation treatment patterns for breast cancer brain metastases: an NCDB analysis}},
journal = {Breast cancer research and treatment},
year = {2026},
month = apr,
volume = {217},
number = {2},
pages = {26},
publisher = {Springer Science+Business Media},
issn = {0167-6806},
doi = {10.1007/s10549-026-07955-z},
url = {https://doi.org/10.1007/s10549-026-07955-z},
pmid = {42018017},
pmcid = {PMC13102853}
}

RIS

TY - JOUR
AU - Pathmarajah, Thamilini
AU - Gokun, Yevgeniya
AU - Williams, Nicole
AU - Sizemore, Gina M.
AU - Lefebvre, Heather
AU - Gatti-Mays, Margaret E.
AU - Slover, Brandon
AU - Daniel, Sierra
AU - Jitwatcharakomol, Tanun
AU - Eckstein, Jacob
AU - Andraos, Therese
AU - Young, Rebekah
AU - Grecula, John
AU - Raval, Raju
AU - Singh, Raj
AU - Zhu, Simeng
AU - Blakaj, Dukajin
AU - Chakravarti, Arnab
AU - Palmer, Joshua
AU - Stover, Daniel
AU - Jhawar, Sachin R.
AU - Beyer, Sasha
TI - Radiation treatment patterns for breast cancer brain metastases: an NCDB analysis
T2 - Breast cancer research and treatment
J2 - Breast Cancer Res Treat
PY - 2026
DA - 2026/04/22
VL - 217
IS - 2
SP - 26
SN - 0167-6806
PB - Springer Science+Business Media
DO - 10.1007/s10549-026-07955-z
UR - https://doi.org/10.1007/s10549-026-07955-z
LA - en
ER -

CSL-JSON

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