Marco Trovo1, Carlo Furlan2, Jerry Polesel3, Francesco Fiorica4, Stefano Arcangeli5, Niccolò Giaj-Levra6, Filippo Alongi6, Alessandro Del Conte7, Loredana Militello7, Elena Muraro8, Debora Martorelli8, Simon Spazzapan9, Massimiliano Berretta7. 1. Department of Radiation Oncology, Udine General Hospital, Udine, Italy. Electronic address: marcotrovo33@hotmail.com. 2. Department of Radiation Oncology, Udine General Hospital, Udine, Italy. 3. Department of Epidemiology and Biostatistics, Centro di Riferimento Oncologico of Aviano, Italy. 4. Department of Radiation Oncology, University Hospital Ferrara, Italy. 5. Department of Radiation Oncology, San Camillo and Forlanini Hospitals, Rome, Italy. 6. Department of Radiation Oncology, Sacro Cuore Cancer Care Center Hospital, Italy. 7. Department of Medical Oncology, Centro di Riferimento Oncologico of Aviano, Italy. 8. Department of Translational Research, Centro di Riferimento Oncologico of Aviano, Italy. 9. Department of Radiation Oncology, Sacro Cuore Cancer Care Center Hospital, Italy; Department of Medical Oncology, Centro di Riferimento Oncologico of Aviano, Italy.
Abstract
BACKGROUND AND PURPOSE: We conducted a prospective phase II multicentric trial to determine if radical radiation therapy to all metastatic sites might improve the progression-free survival (PFS) in oligometastatic breast cancer patients. Secondary endpoints were local control (LC), overall survival (OS) and toxicity. METHODS AND MATERIALS: Inclusion criteria were the following: oligometastatic breast cancer with ≤5 metastatic sites, FDG-PET/CT staging, no brain metastases, primary tumor controlled. Radiotherapy could be delivered using stereotactic body radiotherapy (SBRT) technique or fractionated intensity modulated radiotherapy (IMRT). SBRT consisted of 30-45Gy in 3 fractions, while IMRT was delivered to a total dose of 60Gy in 25 fractions. We hypothesized that radical radiation therapy could increase the PFS from 30% (according to the published literature) to 50% at two years. RESULTS: 54 Patients with 92 metastatic lesions were enrolled. Forty-four were treated with SBRT, and 10 with IMRT. Forty-eight (89%) patients received a form of systemic therapy concomitantly to radiation therapy. Sites of metastatic disease were the following: bones 60 lesions, lymph nodes 23 lesions, lung 4 lesions, liver 5 lesions. After a median follow-up of 30months (range, 6-55months), 1- and 2-year PFS was 75% and 53%, respectively. Two-year LC and OS were 97% and 95%, respectively. Radiation therapy was well tolerated, and no Grade ≥3 toxicity was documented. Grade 2 toxicity were pain and fatigue in 2 cases. CONCLUSIONS: Patients with oligometastatic breast cancer treated with radical radiotherapy to all metastatic sites may achieve long-term progression-free survival, without significant treatment-related toxicity. While waiting for data from randomized trials, the use of radical radiation therapy to all metastatic sites in patients with oligometastatic breast cancer should be considered a valuable option, and its recommendation should be individualized.
BACKGROUND AND PURPOSE: We conducted a prospective phase II multicentric trial to determine if radical radiation therapy to all metastatic sites might improve the progression-free survival (PFS) in oligometastatic breast cancerpatients. Secondary endpoints were local control (LC), overall survival (OS) and toxicity. METHODS AND MATERIALS: Inclusion criteria were the following: oligometastatic breast cancer with ≤5 metastatic sites, FDG-PET/CT staging, no brain metastases, primary tumor controlled. Radiotherapy could be delivered using stereotactic body radiotherapy (SBRT) technique or fractionated intensity modulated radiotherapy (IMRT). SBRT consisted of 30-45Gy in 3 fractions, while IMRT was delivered to a total dose of 60Gy in 25 fractions. We hypothesized that radical radiation therapy could increase the PFS from 30% (according to the published literature) to 50% at two years. RESULTS: 54 Patients with 92 metastatic lesions were enrolled. Forty-four were treated with SBRT, and 10 with IMRT. Forty-eight (89%) patients received a form of systemic therapy concomitantly to radiation therapy. Sites of metastatic disease were the following: bones 60 lesions, lymph nodes 23 lesions, lung 4 lesions, liver 5 lesions. After a median follow-up of 30months (range, 6-55months), 1- and 2-year PFS was 75% and 53%, respectively. Two-year LC and OS were 97% and 95%, respectively. Radiation therapy was well tolerated, and no Grade ≥3 toxicity was documented. Grade 2 toxicity were pain and fatigue in 2 cases. CONCLUSIONS:Patients with oligometastatic breast cancer treated with radical radiotherapy to all metastatic sites may achieve long-term progression-free survival, without significant treatment-related toxicity. While waiting for data from randomized trials, the use of radical radiation therapy to all metastatic sites in patients with oligometastatic breast cancer should be considered a valuable option, and its recommendation should be individualized.
Authors: Rohan R Katipally; Sean P Pitroda; Aditya Juloori; Steven J Chmura; Ralph R Weichselbaum Journal: Nat Rev Clin Oncol Date: 2022-07-12 Impact factor: 65.011
Authors: C Fabregat-Franco; A Stradella; V Navarro; J Linares; M Galdeano; S Recalde; R Velasco; M Simo; A Fernadez; A C Venthecourt; C Falo; S Vazquez; M Bergamino; R Villanueva; S Pernas; M J Gil-Gil Journal: Clin Transl Oncol Date: 2021-03-11 Impact factor: 3.405