Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer
Purpose/Objective: Oligometastatic disease (OMD) and oligoprogressive disease (OPD) describe tumor states with a limited metastasization. In contrast to other disease states, treatment of OMD or OPD has not yet become common for breast cancer. We sought to understand the outcomes and toxicities of t...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-06-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fonc.2020.00987/full |
| _version_ | 1819229379879763968 |
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| author | Fabian Weykamp Fabian Weykamp Fabian Weykamp Laila König Laila König Laila König Katharina Seidensaal Katharina Seidensaal Katharina Seidensaal Tobias Forster Tobias Forster Tobias Forster Philipp Hoegen Philipp Hoegen Philipp Hoegen Sati Akbaba Sati Akbaba Sati Akbaba Stephan Mende Stephan Mende Stephan Mende Stefan E. Welte Stefan E. Welte Stefan E. Welte Thomas M. Deutsch Andreas Schneeweiss Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Juliane Hörner-Rieber Juliane Hörner-Rieber Juliane Hörner-Rieber Juliane Hörner-Rieber |
| author_facet | Fabian Weykamp Fabian Weykamp Fabian Weykamp Laila König Laila König Laila König Katharina Seidensaal Katharina Seidensaal Katharina Seidensaal Tobias Forster Tobias Forster Tobias Forster Philipp Hoegen Philipp Hoegen Philipp Hoegen Sati Akbaba Sati Akbaba Sati Akbaba Stephan Mende Stephan Mende Stephan Mende Stefan E. Welte Stefan E. Welte Stefan E. Welte Thomas M. Deutsch Andreas Schneeweiss Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Juliane Hörner-Rieber Juliane Hörner-Rieber Juliane Hörner-Rieber Juliane Hörner-Rieber |
| author_sort | Fabian Weykamp |
| collection | DOAJ |
| description | Purpose/Objective: Oligometastatic disease (OMD) and oligoprogressive disease (OPD) describe tumor states with a limited metastasization. In contrast to other disease states, treatment of OMD or OPD has not yet become common for breast cancer. We sought to understand the outcomes and toxicities of this treatment paradigm.Material/Methods: We retrospectively analyzed female breast cancer patients with OMD (≤3 metastases) or OPD (1 progressive lesion) who received stereotactic body radiotherapy (SBRT) for their respective extracranial metastatic lesions between 01/2002 and 07/2019. Survival analysis was performed using the Kaplan-Meier method with log-rank test being used for evaluation of significance. Cox regression was used to detect prognostic outcome factors. Toxicity was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE v. 5.0).Results: Forty-six patients (70% OMD; 30% OPD) with 58 lesions met criteria for inclusion. The majority of treatments (34 out of 58; 58.6%) were delivered from 2017 to 2018. Treatment sites were bone, liver, lung [n = 19 (33%) for each site], and adrenal gland [n = 1 (1%)]. Median biologically effective dose (BED at α/β = 10) was 81.6 Gy (range: 45–112.5 Gy) and median planning target volume was 36.60 mL (range: 3.76–311.00 mL). At 2 years, local control (LC) was 89%, distant control (DC) was 44%, progression free survival (PFS) was 17% and overall survival (OS) was 62%. Multivariate analysis identified the diagnosis of a solitary metastasis as an independent prognostic factor for superior DC (HR = 0.186, CI [0.055; 0.626], p = 0.007) and PFS (HR = 0.363, CI [0.152; 0.863], p = 0.022). OS was independently inferior for patients treated at a higher age (HR = 5.788, CI [1.077; 31.119] p = 0.041). Nine (15.5%) grade I° and one (1.7%) grade II° toxicities were recorded, with no grade III° or higher toxicities.Conclusion: Extracranial SBRT in breast cancer patients with OMD or OPD was well-tolerated with excellent LC. SBRT should especially be offered to younger OMD and OPD breast cancer patients with only one metastasis. The increase in utilization since 2017 points toward a growing acceptance of SBRT for OMD and OPD in breast cancer. |
| first_indexed | 2024-12-23T11:12:15Z |
| format | Article |
| id | doaj.art-7e010798e1494088934474ee3aa97efd |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-23T11:12:15Z |
| publishDate | 2020-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-7e010798e1494088934474ee3aa97efd2022-12-21T17:49:18ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2020-06-011010.3389/fonc.2020.00987523609Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast CancerFabian Weykamp0Fabian Weykamp1Fabian Weykamp2Laila König3Laila König4Laila König5Katharina Seidensaal6Katharina Seidensaal7Katharina Seidensaal8Tobias Forster9Tobias Forster10Tobias Forster11Philipp Hoegen12Philipp Hoegen13Philipp Hoegen14Sati Akbaba15Sati Akbaba16Sati Akbaba17Stephan Mende18Stephan Mende19Stephan Mende20Stefan E. Welte21Stefan E. Welte22Stefan E. Welte23Thomas M. Deutsch24Andreas Schneeweiss25Jürgen Debus26Jürgen Debus27Jürgen Debus28Jürgen Debus29Jürgen Debus30Jürgen Debus31Juliane Hörner-Rieber32Juliane Hörner-Rieber33Juliane Hörner-Rieber34Juliane Hörner-Rieber35Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Obstetrics and Gynecology, Heidelberg University Hospital, Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg University Hospital, Heidelberg, GermanyClinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, GermanyGerman Cancer Consortium (DKTK), Partner Site Heidelberg, Heidelberg, GermanyDepartment of Radiation Oncology, Heidelberg University Hospital, Heidelberg, GermanyHeidelberg Institute of Radiation Oncology (HIRO), Heidelberg, GermanyNational Center for Tumor Diseases (NCT), Heidelberg, GermanyClinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, GermanyPurpose/Objective: Oligometastatic disease (OMD) and oligoprogressive disease (OPD) describe tumor states with a limited metastasization. In contrast to other disease states, treatment of OMD or OPD has not yet become common for breast cancer. We sought to understand the outcomes and toxicities of this treatment paradigm.Material/Methods: We retrospectively analyzed female breast cancer patients with OMD (≤3 metastases) or OPD (1 progressive lesion) who received stereotactic body radiotherapy (SBRT) for their respective extracranial metastatic lesions between 01/2002 and 07/2019. Survival analysis was performed using the Kaplan-Meier method with log-rank test being used for evaluation of significance. Cox regression was used to detect prognostic outcome factors. Toxicity was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE v. 5.0).Results: Forty-six patients (70% OMD; 30% OPD) with 58 lesions met criteria for inclusion. The majority of treatments (34 out of 58; 58.6%) were delivered from 2017 to 2018. Treatment sites were bone, liver, lung [n = 19 (33%) for each site], and adrenal gland [n = 1 (1%)]. Median biologically effective dose (BED at α/β = 10) was 81.6 Gy (range: 45–112.5 Gy) and median planning target volume was 36.60 mL (range: 3.76–311.00 mL). At 2 years, local control (LC) was 89%, distant control (DC) was 44%, progression free survival (PFS) was 17% and overall survival (OS) was 62%. Multivariate analysis identified the diagnosis of a solitary metastasis as an independent prognostic factor for superior DC (HR = 0.186, CI [0.055; 0.626], p = 0.007) and PFS (HR = 0.363, CI [0.152; 0.863], p = 0.022). OS was independently inferior for patients treated at a higher age (HR = 5.788, CI [1.077; 31.119] p = 0.041). Nine (15.5%) grade I° and one (1.7%) grade II° toxicities were recorded, with no grade III° or higher toxicities.Conclusion: Extracranial SBRT in breast cancer patients with OMD or OPD was well-tolerated with excellent LC. SBRT should especially be offered to younger OMD and OPD breast cancer patients with only one metastasis. The increase in utilization since 2017 points toward a growing acceptance of SBRT for OMD and OPD in breast cancer.https://www.frontiersin.org/article/10.3389/fonc.2020.00987/fulloligometastaticoligoprogressionstereotactic body radiotherapy (SBRT)breast cancerlocal controlprogression free survival |
| spellingShingle | Fabian Weykamp Fabian Weykamp Fabian Weykamp Laila König Laila König Laila König Katharina Seidensaal Katharina Seidensaal Katharina Seidensaal Tobias Forster Tobias Forster Tobias Forster Philipp Hoegen Philipp Hoegen Philipp Hoegen Sati Akbaba Sati Akbaba Sati Akbaba Stephan Mende Stephan Mende Stephan Mende Stefan E. Welte Stefan E. Welte Stefan E. Welte Thomas M. Deutsch Andreas Schneeweiss Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Jürgen Debus Juliane Hörner-Rieber Juliane Hörner-Rieber Juliane Hörner-Rieber Juliane Hörner-Rieber Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer Frontiers in Oncology oligometastatic oligoprogression stereotactic body radiotherapy (SBRT) breast cancer local control progression free survival |
| title | Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer |
| title_full | Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer |
| title_fullStr | Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer |
| title_full_unstemmed | Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer |
| title_short | Extracranial Stereotactic Body Radiotherapy in Oligometastatic or Oligoprogressive Breast Cancer |
| title_sort | extracranial stereotactic body radiotherapy in oligometastatic or oligoprogressive breast cancer |
| topic | oligometastatic oligoprogression stereotactic body radiotherapy (SBRT) breast cancer local control progression free survival |
| url | https://www.frontiersin.org/article/10.3389/fonc.2020.00987/full |
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