Gion Maria, Saavedra Cristina, Perez-Garcia Jose, Cortes Javier
Medical Oncology Department, Ramón y Cajal University Hospital, 28034 Madrid, Spain.
Instituto Ramón Y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain.
Cancers (Basel). 2022 Oct 25;14(21):5229. doi: 10.3390/cancers14215229.
Although metastatic breast cancer remains an incurable disease, there are patients with a limited number of metastatic lesions that, in addition to systemic therapy, can be treated with "radical therapy" and sometimes reach the status of no long-term evidence of disease. Whether or not these patients can be considered cured is still a matter of debate. Unfortunately, the definition of the oligometastatic disease remains unclear, and it can occur with multiple different presentations. The absence of remarkable biomarkers, the difficulty in designing the appropriate clinical trials, and the failure to offer this group of patients radical approaches in advanced-stage clinical trials are just some of the current problems that we face in treating patients with oligometastatic breast cancer. Although most of the data come from retrospective studies and do not use the same definition of "oligometastatic disease," here we review the main studies exploring the role of surgery or radiotherapy in patients with the oligometastatic disease and the different results. Some, but not all, studies have shown an increase in survival when surgery and/or radiotherapy were performed for oligometastatic disease. However, better clinical trial designs are needed to confirm the role of "aggressive" approaches for patients with breast cancer and oligometastatic disease.
尽管转移性乳腺癌仍然是一种无法治愈的疾病，但仍有一些患者的转移病灶数量有限，除了进行全身治疗外，还可以接受“根治性治疗”，有时能达到长期无疾病证据的状态。这些患者是否能被视为治愈仍存在争议。不幸的是，寡转移疾病的定义仍不明确，且可能有多种不同表现形式。缺乏显著的生物标志物、难以设计合适的临床试验以及在晚期临床试验中未能为这组患者提供根治性方法，只是我们在治疗寡转移乳腺癌患者时目前面临的部分问题。尽管大多数数据来自回顾性研究且未采用相同的“寡转移疾病”定义，但在此我们回顾了探索手术或放疗在寡转移疾病患者中的作用及不同结果的主要研究。一些（但并非全部）研究表明，对寡转移疾病进行手术和/或放疗时生存率有所提高。然而，需要更好的临床试验设计来证实“积极”治疗方法对乳腺癌寡转移疾病患者的作用。
