本研究旨在评估高颅内负荷和脑转移症状对 HER-2 阳性乳腺癌患者治疗结果的影响。通过回顾性分析，我们探讨了HER-2靶向治疗单独应用或联合其他治疗方式后的颅内反应，并进一步阐明了治疗效果与颅内无进展生存期（PFS）、总生存期（OS）、对HER-2过表达乳腺癌脑转移病例进行回顾性分析。审查临床记录以提取患者人口统计数据、治疗方式和颅内疾病特征。在诊断和初始治疗后对颅内肿瘤负荷进行量化。高颅内肿瘤负荷定义为总转移体积> 15 cc，或最大病灶> 3 cm。使用既定标准评估反应。确定颅内疾病参数与颅内无进展生存期（PFS）和总生存期（OS）之间的相关性。该研究包括 65 名 HER-2 过表达乳腺癌和脑转移患者。 69.2% 的患者在诊断脑转移时出现症状。单独使用 HER-2 靶向治疗或与其他方式联合治疗可产生显着的颅内缓解，其中 81.5% 的患者在治疗开始后 3 个月内至少实现部分缓解。高颅内负荷患者的中位颅内 PFS 和 OS 分别为 9 个月和 22 个月。颅内负荷高且诊断时有症状的患者表现出与颅内负荷较低且无症状的患者相比，PFS 和 OS 更差（p < 0.05）。Her-2 过表达乳腺癌和脑转移面临重大挑战，特别是颅内负荷高的患者肿瘤负荷，这与较差的结果和较高的软脑膜转移发生率相关。大多数患者对初始治疗有积极反应，尤其是抗 HER-2 治疗联合放疗。较大的肿瘤需要更全面的治疗方法，例如 WBRT 和 SRS。影响颅内肿瘤控制的关键因素包括 Ki-67 指数、颅内肿瘤负荷以及诊断后持续使用 HER-2 靶向治疗。版权所有 © 2024 Li、Zhen、Ai、Lai、Wang 和 Cai。

This study aimed to evaluate the impact of high intracranial burden and symptomatic presentation of brain metastases on treatment outcomes in patients with HER-2 positive breast cancer. Through a retrospective analysis, we explored the intracranial responses following the application of HER-2 targeted therapy alone or in combination with other modalities and further elucidated the relationship between treatment efficacy, intracranial progression-free survival (PFS), overall survival (OS), and the burden of intracranial lesions and symptomatic presentations.A retrospective analysis was conducted on cases of HER-2 overexpressing breast cancer patients with brain metastases. Clinical records were reviewed to extract patient demographics, treatment modalities, and intracranial disease characteristics. Intracranial tumor burden was quantified at diagnosis and post-initial treatment. High intracranial tumor burden was defined as either total metastatic volume >15 cc, or the largest lesion >3 cm. Responses were assessed using established criteria. The correlation between intracranial disease parameters and intracranial progression-free survival (PFS) and overall survival (OS) was determined.The study comprised 65 patients with HER-2 overexpression breast cancer and brain metastases. Symptomatic presentation was observed in 69.2% of patients at the diagnosis of brain metastases. Treatment with HER-2 target therapy alone or in combination with other modalities resulted in substantial intracranial responses, with 81.5% achieving at least a partial response at 3 months from therapy initiation. Median intracranial PFS and OS for patients with high intracranial burden were 9 and 22 months, respectively. Patients with high intracranial burden and symptomatic presentation at diagnosis demonstrated worse PFS and OS to those with lower burden and absence of symptoms (p < 0.05 for each).Her-2 overexpressing breast cancer and brain metastases face significant challenges, particularly those with high intracranial tumor burden, which correlates with poorer outcomes and higher incidence of leptomeningeal metastasis. Most patients responded positively to initial therapies, especially anti-HER-2 treatments combined with radiotherapy. Larger tumors necessitated more comprehensive treatment approaches, such as WBRT and SRS. Key factors influencing intracranial tumor control included the Ki-67 index, intracranial tumor burden, and continuous use of HER-2 targeted therapy post-diagnosis.Copyright © 2024 Li, Zhen, Ai, Lai, Wang and Cai.