Stereotactic Ablative Radiotherapy for Bone-Only Oligometastatic Breast Cancer: On a Quest to Find the Optimum Cohort


Yilmaz M. T., Gultekin M., YÜCE SARI S., Kumru T., Kivanc H., ÖZYİĞİT G., ...Daha Fazla

CLINICAL ONCOLOGY, cilt.37, 2025 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 37
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1016/j.clon.2024.103670
  • Dergi Adı: CLINICAL ONCOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CINAHL, EMBASE, MEDLINE
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Aims: We aimed to evaluate the treatment outcomes and associated prognostic factors in breast cancer (BC) patients who had bone-only oligometastatic disease (OMD) and we tried to determine the subgroup that would benefit most from stereotactic ablative radiotherapy (SABR). Materials and methods: We enrolled 47 patients with a total of 63 lesions with bone-only oligometastatic BC who underwent SABR for all bone lesions between July 2013 and March 2022. Cases with bone-only metastatic disease with up to 5 metastatic lesions that can be safely treated with SABR were included in this study. All statistical analyses were performed using SPSS 23.0 software (SPSS, Chicago, IL). Results: The median follow-up time was 34 months. The 2-and 5-year overall survival (OS) rates were 90% and 66%, and the progression-free survival (PFS) rates were 49% and 29%, respectively. The local control rate in the SABR-treated foci was 85%. In multivariate analysis, OMD state (genuine vs. induced), de-novo OMD state (synchronous vs. metachronous), and histology (luminal vs. HER-2 enriched) were prognostic for OS. Molecular subtype switch was observed in 21 (42%) patients, and 0% PFS was observed in 5 years in patients with phenotypic discordance. SABR was well tolerated and there were no >grade 4 acute or late toxicities. Conclusion: Our study showed that in patients with bone-only OMD, in HER2-enriched subtypes with genuine & de-novo & synchronous OMD, SABR should be strongly considered for all metastatic foci, especially if there is phenotypic discordance in the primary tumor and metastasis. (c) 2024 The Royal College of Radiologists. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.