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Stereotactic Body Radiotherapy (Sbrt) and Concomitant Systemic Therapy in Oligoprogressive Breast Cancer Patients Publisher Pubmed



Nicosia L1 ; Figlia V1 ; Ricottone N2 ; Cuccia F1 ; Mazzola R1 ; Giajlevra N1 ; Ricchetti F1 ; Rigo M1 ; Jafari F3 ; Maria Magrini S4 ; Girlando A2 ; Alongi F1, 5
Authors
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Authors Affiliations
  1. 1. Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, Negrar, Verona, 37034, Italy
  2. 2. Unita Operativa di Radioterapia, Humanitas Istituto Clinico Catanese, Misterbianco, Italy
  3. 3. Radiation Oncology Department, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
  5. 5. University of Brescia, Brescia, Italy

Source: Clinical and Experimental Metastasis Published:2022


Abstract

Breast cancer is a heterogenous disease with a deep tailoring level. Evidence is accumulating on the role of stereotactic body radiotherapy (SBRT) in the management of oligometastatic disease, however this is limited in breast cancer. The aim of the present study is to show the effectiveness of SBRT in delaying the switch to a subsequent systemic treatment in oligoprogressive breast cancer patients. Retrospective analysis from two Institutions. Primary endpoint: time to next systemic treatment (NEST). Secondary endpoints: freedom from local progression (FLP), time to the polymetastatic conversion (tPMC) and overall survival (OS). One-hundred fifty-three (153) metastases in 79 oligoprogressive breast cancer patients were treated with SBRT. Median follow-up 24 months. Median NEST 8 months. Predictive factor of NEST at the multivariate analysis (MVA) was the number of treated oligometastases (HR 1.765, 95%CI 1.322–2.355; p = < 0.01). Systemic treatment after SBRT was changed in 29 patients for polymetastatic progression and in 10 patients for oligometastatic progression < 6 months after SBRT. The 2-year FLP in the overall population was 86.7%. A biological effective dose (BED) > 70Gy10 was associated with improved FLP (90% versus 74.2%). The median tPMC was 10 months. At the MVA the only factors significantly associated with tPMC were the number of oligometastases (HR 1.172, 95%CI 1.000–1.368; p = 0.03), and the local control of the treated metastases (HR 2.726, CI95% 1.108–6.706; p = 0.02). SBRT can delay the switch to a subsequent systemic treatment, however patient selection is necessary. Several predictive factors for treatment tailoring have been identified. © 2022, The Author(s), under exclusive licence to Springer Nature B.V.