Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy
Background: The study evaluates the frequency of and indications for bone-metastases (BM)-related surgery and/or radiotherapy in the palliative breast cancer (BC) situation and analyzes in which phase of the palliative disease course surgery and/or radiotherapy was applied. Methods: 340 patients who...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014-05-01
|
| Series: | Journal of Bone Oncology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212137414000189 |
| _version_ | 1819170983926300672 |
|---|---|
| author | Kirsten Steinauer Dorothy Jane Huang Serenella Eppenberger-Castori Esther Amann Uwe Güth |
| author_facet | Kirsten Steinauer Dorothy Jane Huang Serenella Eppenberger-Castori Esther Amann Uwe Güth |
| author_sort | Kirsten Steinauer |
| collection | DOAJ |
| description | Background: The study evaluates the frequency of and indications for bone-metastases (BM)-related surgery and/or radiotherapy in the palliative breast cancer (BC) situation and analyzes in which phase of the palliative disease course surgery and/or radiotherapy was applied.
Methods: 340 patients who developed distant metastatic disease (DMD) and died (i.e. patients with completed disease courses) were analyzed.
Results: From the entire study cohort, 237 patients (69.7%) were diagnosed with BM. Out of these, 116 patients (48.9%) received BM-related radiotherapy and/or surgery during the palliative situation.
Radiotherapy: 108 patients (45.6%) received 161 series (range: 1–5) with 217 volumina (range: 1–8) on 300 osseous sites. At 75.3% of the radiated sites, the spine was the most frequent radiated location. Eighty-eight series (54.7%) were performed in the first third of the metastatic disease survival (MDS) period. The median survival after radiotherapy was 14 months (range: 0.2–121 months).
Surgery: In 37 patients (15.6%), 50 procedures (range: 1–4) were necessary to stabilize BM. The femur predominated with 56.0% of the procedures. Twenty procedures (40.0%) were performed in the first third of survival follow-up. The median survival after surgery was 13.5 months (range: 0.5–49 months).
BC patients with BM had a significantly improved MDS when radiotherapy and/or surgery for skeletal metastases was embedded in the palliative approach (27.5 months vs. 19.5 months, p<0.001). From the 118 patients who had a MDS of ≥24 months, the majority (54.2%) had BM-related radiotherapy and/or surgery during the palliative course.
Conclusions: Metastatic BC has become increasingly viewed as a chronic disease process. In a general palliative therapy approach, which allows for treatment according to the principles of a chronic disease, non-systemic therapy for BM, in particular radiotherapy, has a clearly established role in the therapy concept. |
| first_indexed | 2024-12-22T19:44:04Z |
| format | Article |
| id | doaj.art-894212b0aabd429694ebfb939f548399 |
| institution | Directory Open Access Journal |
| issn | 2212-1374 |
| language | English |
| last_indexed | 2024-12-22T19:44:04Z |
| publishDate | 2014-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Bone Oncology |
| spelling | doaj.art-894212b0aabd429694ebfb939f5483992022-12-21T18:14:44ZengElsevierJournal of Bone Oncology2212-13742014-05-0132546010.1016/j.jbo.2014.05.001Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapyKirsten Steinauer0Dorothy Jane Huang1Serenella Eppenberger-Castori2Esther Amann3Uwe Güth4Cantonal Hospital Winterthur, Department of Radiation Therapy and Radiation Oncology, Brauerstrasse 15, CH-8401 Winterthur, SwitzerlandUniversity Hospital Basel (UHB), Department of Gynecology and Obstetrics, Spitalstrasse 21, CH-4031 Basel, SwitzerlandUHB, Institute of Pathology, Schönbeinstrasse 40, CH-4031 Basel, SwitzerlandBreast Center “SenoSuisse”, Brauerstrasse 15, CH-8401 Winterthur, SwitzerlandBreast Center “SenoSuisse”, Brauerstrasse 15, CH-8401 Winterthur, SwitzerlandBackground: The study evaluates the frequency of and indications for bone-metastases (BM)-related surgery and/or radiotherapy in the palliative breast cancer (BC) situation and analyzes in which phase of the palliative disease course surgery and/or radiotherapy was applied. Methods: 340 patients who developed distant metastatic disease (DMD) and died (i.e. patients with completed disease courses) were analyzed. Results: From the entire study cohort, 237 patients (69.7%) were diagnosed with BM. Out of these, 116 patients (48.9%) received BM-related radiotherapy and/or surgery during the palliative situation. Radiotherapy: 108 patients (45.6%) received 161 series (range: 1–5) with 217 volumina (range: 1–8) on 300 osseous sites. At 75.3% of the radiated sites, the spine was the most frequent radiated location. Eighty-eight series (54.7%) were performed in the first third of the metastatic disease survival (MDS) period. The median survival after radiotherapy was 14 months (range: 0.2–121 months). Surgery: In 37 patients (15.6%), 50 procedures (range: 1–4) were necessary to stabilize BM. The femur predominated with 56.0% of the procedures. Twenty procedures (40.0%) were performed in the first third of survival follow-up. The median survival after surgery was 13.5 months (range: 0.5–49 months). BC patients with BM had a significantly improved MDS when radiotherapy and/or surgery for skeletal metastases was embedded in the palliative approach (27.5 months vs. 19.5 months, p<0.001). From the 118 patients who had a MDS of ≥24 months, the majority (54.2%) had BM-related radiotherapy and/or surgery during the palliative course. Conclusions: Metastatic BC has become increasingly viewed as a chronic disease process. In a general palliative therapy approach, which allows for treatment according to the principles of a chronic disease, non-systemic therapy for BM, in particular radiotherapy, has a clearly established role in the therapy concept.http://www.sciencedirect.com/science/article/pii/S2212137414000189Breast cancerBone metastasesPalliative radiotherapyPalliative surgery |
| spellingShingle | Kirsten Steinauer Dorothy Jane Huang Serenella Eppenberger-Castori Esther Amann Uwe Güth Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy Journal of Bone Oncology Breast cancer Bone metastases Palliative radiotherapy Palliative surgery |
| title | Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy |
| title_full | Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy |
| title_fullStr | Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy |
| title_full_unstemmed | Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy |
| title_short | Bone metastases in breast cancer: Frequency, metastatic pattern and non-systemic locoregional therapy |
| title_sort | bone metastases in breast cancer frequency metastatic pattern and non systemic locoregional therapy |
| topic | Breast cancer Bone metastases Palliative radiotherapy Palliative surgery |
| url | http://www.sciencedirect.com/science/article/pii/S2212137414000189 |
| work_keys_str_mv | AT kirstensteinauer bonemetastasesinbreastcancerfrequencymetastaticpatternandnonsystemiclocoregionaltherapy AT dorothyjanehuang bonemetastasesinbreastcancerfrequencymetastaticpatternandnonsystemiclocoregionaltherapy AT serenellaeppenbergercastori bonemetastasesinbreastcancerfrequencymetastaticpatternandnonsystemiclocoregionaltherapy AT estheramann bonemetastasesinbreastcancerfrequencymetastaticpatternandnonsystemiclocoregionaltherapy AT uweguth bonemetastasesinbreastcancerfrequencymetastaticpatternandnonsystemiclocoregionaltherapy |