Multidisciplinary Breast Cancer Unit, Radiation Oncology Service, University Hospital of Navarre, Pamplona, Spain.
Service of Radiotherapy Oncology, University Hospital of Navarre, Pamplona, Spain.
Clin Transl Oncol. 2023 Oct;25(10):2861-2867. doi: 10.1007/s12094-023-03170-0. Epub 2023 Apr 27.
Oligometastasic breast cancer (OMBC) consists of breast cancer patient with a limited number of systemic metastases (≤ 5), all of them candidates for local ablative treatment with the intention of achieving long-term control of the metastasis and, eventually, an increase in survival The first consensus for the management of patients with oligometastatic breast cancer (OMBC) was published in 2007, establishing that a more aggressive multidisciplinary strategy is recommended in order to increase the survival while maintaining a good quality of life. The current scientific evidence is based on observational studies, mainly retrospective, systematic reviews and meta-analyses, and only a randomized nonexclusive study of oligometastatic (OM) published. All trials with Stereotactic Body Radiation Therapy (SBRT) in OM cancer have shown excellent tolerance and good local control, although first trials on Lung SBRT did not prove so excellent tolerance and had some deaths due to bronchus irradiation and secondary hemoptysis. There are multiple ongoing studies researching the benefit of SBRT in oligometastatic breast cancer. Despite the lack of impact on survival seen in the NRG BR-002 Trial, SBRT probably allows the delay of the systemic treatment until progression, and so, improves the quality of life of patients. We have to wait for the results of the ongoing and future studies for clarification of the role of local treatment in OMBC.
寡转移乳腺癌（OMBC）是指乳腺癌患者存在有限数量的全身性转移灶（≤5 个），所有这些转移灶都适合进行局部消融治疗，以期长期控制转移灶，并最终提高生存率。2007 年首次发布了寡转移乳腺癌（OMBC）患者管理的共识，确立了更积极的多学科策略，以提高生存率，同时保持良好的生活质量。目前的科学证据基于观察性研究，主要是回顾性研究、系统评价和荟萃分析，只有一项寡转移（OM）的随机非排他性研究发表。所有使用立体定向体部放射治疗（SBRT）治疗 OM 癌症的试验均显示出良好的耐受性和良好的局部控制，尽管首次对肺部 SBRT 的试验并未显示出如此出色的耐受性，并且由于支气管照射和继发性咯血导致一些死亡。目前有多项正在进行的研究探讨 SBRT 在寡转移乳腺癌中的获益。尽管 NRG BR-002 试验未观察到对生存的影响，但 SBRT 可能会延迟全身性治疗直至进展，从而提高患者的生活质量。我们需要等待正在进行和未来研究的结果，以明确局部治疗在 OMBC 中的作用。
