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Open Access 08-05-2022 | Metastasis | Review Article

Oligometastasis in breast cancer—current status and treatment options from a radiation oncology perspective

Authors: Prof. Dr. Marc D. Piroth, David Krug, Petra Feyer, René Baumann, Stephanie Combs, Marciana-Nona Duma, Jürgen Dunst, Gerd Fastner, Rainer Fietkau, Matthias Guckenberger, Wulf Haase, Wolfgang Harms, Thomas Hehr, Felix Sedlmayer, Rainer Souchon, V. Strnad, Wilfried Budach

Published in: Strahlentherapie und Onkologie | Issue 7/2022

Abstract

Evidence from a few small randomized trials and retrospective cohorts mostly including various tumor entities indicates a prolongation of disease free survival (DFS) and overall survival (OS) from local ablative therapies in oligometastatic disease (OMD). However, it is still unclear which patients benefit most from this approach. We give an overview of the several aspects of stereotactic body radiotherapy (SBRT) in extracranial OMD in breast cancer from a radiation oncology perspective. A PubMed search referring to this was conducted. An attempt was made to relate the therapeutic efficacy of SBRT to various prognostic factors. Data from approximately 500 breast cancer patients treated with SBRT for OMD in mostly in small cohort studies have been published, consistently indicating high local tumor control rates and favorable progression-free (PFS) and overall survival (OS). Predictors for a good prognosis after SBRT are favorable biological subtype (hormone receptor positive, HER2 negative), solitary metastasis, bone-only metastasis, and long metastasis-free interval. However, definitive proof that SBRT in OMD breast cancer prolongs DFS or OS is lacking, since, with the exception of one small randomized trial (n = 22 in the SBRT arm), none of the cohort studies had an adequate control group. Further studies are needed to prove the benefit of SBRT in OMD breast cancer and to define adequate selection criteria. Currently, the use of local ablative SBRT should always be discussed in a multidisciplinary tumor board.

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Title: Oligometastasis in breast cancer—current status and treatment options from a radiation oncology perspective
Authors: Prof. Dr. Marc D. Piroth
David Krug
Petra Feyer
René Baumann
Stephanie Combs
Marciana-Nona Duma
Jürgen Dunst
Gerd Fastner
Rainer Fietkau
Matthias Guckenberger
Wulf Haase
Wolfgang Harms
Thomas Hehr
Felix Sedlmayer
Rainer Souchon
V. Strnad
Wilfried Budach
Publication date: 08-05-2022
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Systemic Therapy
Breast Cancer
Breast Cancer
Radiotherapy
Published in: Strahlentherapie und Onkologie / Issue 7/2022
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-022-01938-x

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Oligometastasis in breast cancer—current status and treatment options from a radiation oncology perspective

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