Geovanne Pedro Mauro1, Heloisa de Andrade Carvalho2, Silva Radwanski Stuart3, Max Senna Mano4, Gustavo Nader Marta5. 1. Department of Radiology and Oncology of University of São Paulo, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo and Instituto do Câncer do Estado de São Paulo (ICESP), Av. Dr. Arnaldo, 251, Cerqueira César, Sao Paulo - SP, 01246-000, Brazil. Electronic address: geovanne95@gmail.com. 2. Department of Radiology and Oncology of University of São Paulo, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo and Hospital Sírio-Libanês, Brazil, Av. Dr. Arnaldo, 251, Cerqueira César, Sao Paulo - SP, 01246-000, Brazil. Electronic address: heloisa.carvalho@hc.fm.usp.br. 3. Department of Radiology and Oncology of University of São Paulo, Instituto de Radiologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Arnaldo, 251, Cerqueira César, Sao Paulo - SP, 01246-000, Brazil. Electronic address: srstuart@uol.com.br. 4. Department of Radiology and Oncology of University of São Paulo, Instituto do Câncer do Estado de São Paulo (ICESP) - Faculdade de Medicina da Universidade de São Paulo and Hospital Sírio-Libanês, Brazil, Av. Dr. Arnaldo, 251, Cerqueira César, Sao Paulo - SP, 01246-000, Brazil. Electronic address: max.mano@usp.br. 5. Department of Radiology and Oncology of University of São Paulo, Instituto do Câncer do Estado de São Paulo (ICESP) - Faculdade de Medicina da Universidade de São Paulo and Hospital Sírio-Libanês, Brazil, Av. Dr. Arnaldo, 251, Cerqueira César, Sao Paulo - SP, 01246-000, Brazil. Electronic address: gnmarta@uol.com.br.
Abstract
OBJECTIVES: This study aims to assess the clinical outcomes of patients with metastatic breast cancer (MBC) who underwent local radiation therapy (RT) for the primary site. MATERIAL AND METHODS: Between 2005 and 2013, we retrospectively evaluated patients with MBC who received breast or chest wall RT with or without regional lymph node irradiation. RESULTS: 2761 patients with breast cancer were treated with RT. Of them, 125 women with stage IV breast carcinoma were included. The median follow-up was 15 months (ranging from 3.8 to 168 months), when 54.7% of the patients had died; local progression was observed in 22.8% of the patients. The mean overall survival (OS) and local progression free survival (LoPFS) were 23.4 ± 2.4 months and 45.1 ± 2.9 months, respectively. Three- and five-year overall survival rates were, respectively, 21.2% and 13.3%. Local progression free survival was the same, 67.3%, at three and five years, respectively. Karnofsky Performance Status (KPS) (p = 0.015), number of metastatic sites (p = 0.031), RT dose (p = 0.0001) and hormone therapy (p = 0.0001) were confirmed as independent significant variables correlated with OS. The variables that were independently correlated with LoPFS were the number of previous chemotherapy lines (p = 0.038) and RT dose (p = 0.0001). CONCLUSION: RT of the primary site in patients with MBC is well tolerated. The factors that presented positive impact on survival were good KPS, low disease burden (1-3 metastatic sites), and the use of hormone therapy.
OBJECTIVES: This study aims to assess the clinical outcomes of patients with metastatic breast cancer (MBC) who underwent local radiation therapy (RT) for the primary site. MATERIAL AND METHODS: Between 2005 and 2013, we retrospectively evaluated patients with MBC who received breast or chest wall RT with or without regional lymph node irradiation. RESULTS: 2761 patients with breast cancer were treated with RT. Of them, 125 women with stage IV breast carcinoma were included. The median follow-up was 15 months (ranging from 3.8 to 168 months), when 54.7% of the patients had died; local progression was observed in 22.8% of the patients. The mean overall survival (OS) and local progression free survival (LoPFS) were 23.4 ± 2.4 months and 45.1 ± 2.9 months, respectively. Three- and five-year overall survival rates were, respectively, 21.2% and 13.3%. Local progression free survival was the same, 67.3%, at three and five years, respectively. Karnofsky Performance Status (KPS) (p = 0.015), number of metastatic sites (p = 0.031), RT dose (p = 0.0001) and hormone therapy (p = 0.0001) were confirmed as independent significant variables correlated with OS. The variables that were independently correlated with LoPFS were the number of previous chemotherapy lines (p = 0.038) and RT dose (p = 0.0001). CONCLUSION: RT of the primary site in patients with MBC is well tolerated. The factors that presented positive impact on survival were good KPS, low disease burden (1-3 metastatic sites), and the use of hormone therapy.