Department of Radiation Oncology, Institut Curie Hôpital René Huguenin, Saint Cloud, France.
BMC Cancer. 2010 Nov 17;10:630. doi: 10.1186/1471-2407-10-630.
Data from the Surveillance, Epidemiology, and End Results program and the European Concerted Action on survival and Care of Cancer Patients (EUROCARE) project indicate that about 6% of women newly diagnosed with breast cancer have stage IV disease, representing about 12 600 new cases per year in the United States in 2005. Historically, local therapy of the primary tumor in this setting has been aimed solely at symptom palliation. However, several studies suggest that surgical excision of the primary tumor can prolong these patients' survival.
Exclusive locoregional radiotherapy is an alternative form of locoregional treatment in this setting and may represent an effective alternative to surgery in this setting. Here we discuss current issues regarding exclusive and adjuvant locoregional radiotherapy in breast cancer patients with synchronous metastases.
Several studies suggest that surgery or exclusive irradiation of the primary tumor is associated with better survival in breast cancer patients with synchronous metastases and that exclusive locoregional radiotherapy may represent an effective alternative to surgery in this setting. Results of well-designed prospective studies are needed to re-evaluate treatment of the primary breast tumor in patients with metastases at diagnosis, and to identify those patients who are most likely to benefit.
监测、流行病学和最终结果计划以及欧洲癌症患者生存和护理协同行动（EUROCARE）项目的数据表明，约有 6%的新诊断为乳腺癌的女性患有 IV 期疾病，这代表了 2005 年美国每年约有 12600 例新病例。从历史上看，这种情况下的原发性肿瘤的局部治疗仅旨在缓解症状。然而，一些研究表明，原发性肿瘤的手术切除可以延长这些患者的生存时间。
在这种情况下，单纯局部区域放射治疗是局部区域治疗的另一种形式，并且可能是手术的有效替代方法。在这里，我们讨论了在伴有同步转移的乳腺癌患者中，单纯局部区域放疗和辅助局部区域放疗的当前问题。
几项研究表明，对于伴有同步转移的乳腺癌患者，手术或原发性肿瘤的单纯照射与更好的生存相关，并且单纯局部区域放疗可能是这种情况下手术的有效替代方法。需要进行精心设计的前瞻性研究，以重新评估对诊断时伴有转移的患者的原发性乳腺肿瘤的治疗，并确定最有可能受益的患者。
