Miyata Mari, Ohguri Takayuki, Yahara Katsuya, Yamaguchi Shinsaku, Imada Hajime, Korogi Yukunori
Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu 807-8555, Japan.
Department of Radiology, Kitakyushu General Hospital, 1-1 Higashijonomachi Kokurakita-ku, Kitakyushu 802-8517, Japan.
J Radiat Res. 2018 Jan 1;59(1):58-66. doi: 10.1093/jrr/rrx066.
A new concept designated 'oligo-recurrence (OR)' has been proposed, which indicates one to several distant metastases/recurrences in one or more organs, which can be treated with local therapy, after the primary site of the cancer has been controlled. The purpose of this study was to assess the efficacy and toxicity of salvage radiotherapy (RT) for the second OR of breast cancer. The second OR was defined as once-salvaged patients with OR who had a second failure that was also detected as the state of OR. Twenty-one patients with second OR were treated with salvage RT and were retrospectively analyzed. The sites of the second OR were locoregional recurrence in 7 patients and distant metastasis in 14 patients. Salvage RT was performed at a median total dose of 60 Gy. Nineteen (90%) patients had an objective response. The median overall survival and progression-free survival (PFS) times were 41 and 24 months after salvage RT for the second OR, respectively. The 3-year local (in-field) control (LC) rates were 93%. The toxicities were mild; acute toxicities ≥Grade 3 were seen in one patient with Grade 3 dermatitis, and no late toxicity ≥Grade 2 was observed. In conclusion, salvage RT for the second OR was able to achieve a better LC rate and longer PFS time without inducing severe toxicity, and therefore may be a potentially effective modality for inducing long-term survival in select patients.
一种名为“寡复发（OR）”的新概念已被提出，它指的是在癌症原发部位得到控制后，一个或多个器官出现一至多处远处转移/复发，且可通过局部治疗进行处理的情况。本研究的目的是评估挽救性放疗（RT）对乳腺癌第二次寡复发的疗效和毒性。第二次寡复发定义为曾接受过一次挽救治疗的寡复发患者出现第二次复发，且该复发也被检测为寡复发状态。对21例出现第二次寡复发的患者进行了挽救性放疗并进行回顾性分析。第二次寡复发的部位，7例为局部区域复发，14例为远处转移。挽救性放疗的中位总剂量为60 Gy。19例（90%）患者有客观反应。第二次寡复发患者接受挽救性放疗后的中位总生存期和无进展生存期（PFS）分别为41个月和24个月。3年局部（野内）控制（LC）率为93%。毒性反应较轻；1例患者出现3级皮炎，这是唯一出现≥3级的急性毒性反应，未观察到≥2级的晚期毒性反应。总之，针对第二次寡复发的挽救性放疗能够在不引发严重毒性的情况下实现更好的局部控制率和更长的无进展生存期，因此对于特定患者而言可能是一种潜在有效的诱导长期生存的治疗方式。
