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立体定向体部放疗治疗乳腺癌肝转移的疗效观察。

Treatment outcomes of breast cancer liver metastasis treated with stereotactic body radiotherapy.

机构信息

Department of Radiation Oncology, Baskent University Faculty of Medicine, 01120, Adana, Turkey.

Department of Radiation Oncology, Baskent University Faculty of Medicine, 01120, Adana, Turkey.

出版信息

Breast. 2018 Dec;42:150-156. doi: 10.1016/j.breast.2018.09.006. Epub 2018 Sep 29.

Abstract

BACKGROUND

To assess the outcomes of breast cancer liver metastasis (BCLM) treated with stereotactic body radiotherapy (SBRT) and systemic treatment.

MATERIALS AND METHODS

Patients with oligometastasis at the time of liver metastasis (LM) or who became oligometastatic (≤5 metastases) after systemic treatment were assessed. Twenty-nine liver metastatic lesions were treated with a total of 54 Gy delivered in 3 fractions. The local control (LC), overall survival (OS), and progression-free survival (PFS) rates were calculated using Kaplan-Meier analyses.

RESULTS

A total of 22 patients with 29 liver metastatic lesions treated with liver SBRT between April 2013 and September 2017 were retrospectively analyzed. After a median follow-up time of 16.0 months (range 4.4-59.4 months), 18 patients (82%) had disease recurrence, median of 7.4 months (range 1.0-27.9 months) after completion of liver SBRT. The 1- and 2-year OS rates were 85% and 57%, and the 1- and 2-year PFS rates were 38% and 8%, respectively. The 1- and 2-year LC rates were 100% and 88%, respectively. No significant prognostic factors, including disease extension, size of metastasis, number of liver metastasis and timing of liver metastasis, hormonal status affecting OS, PFS and LC were found. No patients experienced Grade 4 or 5 toxicity; furthermore, only one patient experienced rib fracture 6 months after completion of treatment, and one patient had a duodenal ulcer.

CONCLUSION

This study is the first to evaluate the feasibility of SBRT to BCLM patients. Liver SBRT is a conservative approach with excellent LC and limited toxicities.

摘要

背景

评估立体定向体部放疗(SBRT)联合系统治疗对乳腺癌肝转移(BCLM)的疗效。

材料与方法

评估同时存在肝转移(LM)或经系统治疗后转移灶数少于 5 个的寡转移患者。29 个肝转移灶共接受 54Gy 的 SBRT 治疗,单次剂量 18Gy,共 3 次。采用 Kaplan-Meier 法计算局部控制率(LC)、总生存率(OS)和无进展生存率(PFS)。

结果

2013 年 4 月至 2017 年 9 月间,22 例 29 个肝转移灶接受了 SBRT 治疗,回顾性分析这些患者的临床资料。中位随访时间为 16.0 个月(4.4-59.4 个月),SBRT 治疗后中位疾病复发时间为 7.4 个月(1.0-27.9 个月)。1 年和 2 年 OS 率分别为 85%和 57%,1 年和 2 年 PFS 率分别为 38%和 8%,1 年和 2 年 LC 率分别为 100%和 88%。无显著的预后因素,包括疾病范围、转移灶大小、肝转移灶数目和肝转移发生时间,以及影响 OS、PFS 和 LC 的激素状态。无 4 级或 5 级毒性反应发生;仅 1 例患者在治疗后 6 个月出现肋骨骨折,1 例出现十二指肠溃疡。

结论

本研究首次评估了 SBRT 治疗 BCLM 的可行性。SBRT 是一种保守的治疗方法,具有良好的 LC 和有限的毒性。

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