Beduk Esen Caglayan Selenge, Gultekin Melis, Yildiz Ferah
Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey.
World J Clin Oncol. 2022 Jan 24;13(1):39-48. doi: 10.5306/wjco.v13.i1.39.
Metastatic breast cancer has been historically considered as an incurable disease. Radiotherapy (RT) has been traditionally used for only palliation of the symptoms caused by metastatic lesions. However, in recent years the concept of oligometastatic disease has been introduced in Cancer Medicine as a clinical scenario with a limited number of metastases (≤ 5) and involved organs (≤ 2) with controlled primary tumor. The main hypothesis in oligometastatic disease is that locoregional treatment of primary tumor site and metastasis-directed therapies with surgery and/or RT may improve outcomes. Recent studies have shown that not all metastatic breast cancer patients have the same prognosis, and selected patients with good prognostic features as those younger than 55 years, hormone receptor-positive, limited bone or liver metastases, a low-grade tumor, good performance status, long disease-free interval (> 12 mo), and good response to systemic therapy may provide maximum benefit from definitive treatment procedures to all disease sites. While retrospective and prospective studies on locoregional treatment in oligometastatic breast cancer demonstrated conflicting results, there is an increasing trend in favor of locoregional treatment. Currently, available data also demonstrated the improvements in survival with metastasis-directed therapy in oligometastatic breast cancer. The current review will discuss the concept of oligometastases and provide up-to-date information about the role of RT in oligometastatic breast cancer.
转移性乳腺癌在历史上一直被认为是一种无法治愈的疾病。传统上，放射治疗（RT）仅用于缓解转移性病变引起的症状。然而，近年来，寡转移疾病的概念已被引入癌症医学领域，它是一种转移灶数量有限（≤5个）且累及器官数量有限（≤2个）且原发肿瘤得到控制的临床情况。寡转移疾病的主要假设是，对原发肿瘤部位进行局部区域治疗以及采用手术和/或放疗进行转移灶定向治疗可能会改善预后。最近的研究表明，并非所有转移性乳腺癌患者的预后都相同，而一些具有良好预后特征的患者，如年龄小于55岁、激素受体阳性、骨或肝转移有限、肿瘤分级低、身体状况良好、无病间期长（>12个月）以及对全身治疗反应良好的患者，可能会从针对所有疾病部位的确定性治疗程序中获得最大益处。虽然关于寡转移乳腺癌局部区域治疗的回顾性和前瞻性研究结果相互矛盾，但支持局部区域治疗的趋势正在增加。目前，现有数据也表明寡转移乳腺癌采用转移灶定向治疗可提高生存率。本综述将讨论寡转移的概念，并提供有关放疗在寡转移乳腺癌中作用的最新信息。
