Li Xiaomin, Sun Yu, Tang Liang, Li Yan, Yang Xiaoqin
Division of Breast Surgery, Department of General Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China.
Breast Center, West China Hospital, Sichuan University, Chengdu, China.
Discov Oncol. 2024 Dec 1;15(1):733. doi: 10.1007/s12672-024-01595-9.
The role of local ablative radiotherapy (stereotactic body radiotherapy (SBRT)/stereotactic radiosurgery (SRS)) in the management of metastatic breast cancer (mBC) patients remains unclear. This study aimed to assess the efficacy of SBRT/SRS in oligometastatic and oligoprogressive breast cancer patients.
Totally 80 mBC patients with oligometastatic disease (OMD) and 80 with oligoprogressive disease (OPD) to ≤5 metastatic lesions were retrospectively analyzed. The endpoint was overall survival and progression-free survival, and univariate and multivariate analyses were performed for survival analysis.
Totally 160 mBC cases (80 OMD and 80 OPD cases) were analyzed, with a total of 291 treated metastases. In the study of OMD, we analyzed 30 cases with oligo-recurrence and 50 cases with sync-oligometastases. The median follow-up time was 46 months, and 1-, 2-, and 3-year OS rates for all patients were 89.8%, 77.6%, and 67.3%, respectively, and the 1-, 2-, and 3-year PFS rates were 71.4%, 44.9%, and 34.7% respectively. In multivariate analysis (MVA), treatment for oligometastases and non-triple-negative status predicted favorable OS. In patients with oligometastases, median OS was 58 months, and 1-, 2-, and 3-year OS rates were 100%, 91.7%, and 83.3%, respectively; median OS in patients with oligoprogression was 35 months, and 1-, 2-, and 3-year OS rates were 80%, 64%, and 52%, respectively. In mBC cases with limited brain metastases administered SRS, poor OS was detected in patient age under 45 years (P = 0.041), triple-negative cases (P = 0.025), and those with OPD (P = 0.022). In OMD, a significant improvement in PFS was observed in the oligo-recurrence group compared to the sync-oligometastases group (P = 0.013).
Patients administered local ablative radiotherapy (SBRT/SRS) for oligometastases have better overall survival than those treated for oligoprogression. SBRT/SRS may be beneficial for young and non-triple-negative mBC cases. The presence of oligo-recurrence can predict a favorable prognosis of oligometastases in patients with mBC treated with SBRT/SRS.
局部消融放疗（立体定向体部放疗（SBRT）/立体定向放射外科手术（SRS））在转移性乳腺癌（mBC）患者管理中的作用仍不明确。本研究旨在评估SBRT/SRS在寡转移和寡进展性乳腺癌患者中的疗效。
回顾性分析了80例寡转移疾病（OMD）的mBC患者和80例寡进展疾病（OPD）且转移灶≤5个的患者。终点指标为总生存期和无进展生存期，并进行单因素和多因素分析以进行生存分析。
共分析了160例mBC病例（80例OMD和80例OPD病例），共291个接受治疗的转移灶。在OMD研究中，我们分析了30例寡复发和50例同步寡转移病例。中位随访时间为46个月，所有患者的1年、2年和3年总生存率分别为89.8%、77.6%和67.3%，1年、2年和3年无进展生存率分别为71.4%、44.9%和34.7%。在多因素分析（MVA）中，寡转移灶治疗和非三阴性状态预示着较好的总生存期。在寡转移患者中，中位总生存期为58个月，1年、2年和3年总生存率分别为100%、91.7%和83.3%；寡进展患者的中位总生存期为35个月，1年、2年和3年总生存率分别为80%、64%和52%。在接受SRS治疗的脑转移局限的mBC病例中，年龄小于45岁的患者（P = 0.041）、三阴性病例（P = 0.025）和OPD患者（P = 0.022）的总生存期较差。在OMD中，寡复发组的无进展生存期较同步寡转移组有显著改善（P = 0.013）。
接受寡转移灶局部消融放疗（SBRT/SRS）的患者总生存期优于接受寡进展治疗的患者。SBRT/SRS可能对年轻和非三阴性mBC病例有益。寡复发的存在可预测接受SBRT/SRS治疗的mBC患者寡转移的良好预后。
