Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study
IntroductionStereotactic radiotherapy may improve the prognosis of oligometastatic patients. In the literature, there is very little data available that is specific to breast cancer.Materials and MethodsWe conducted a multicenter retrospective study. The primary objective was to estimate progression...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2021-10-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2021.736690/full |
| _version_ | 1818739315424886784 |
|---|---|
| author | Pauline Lemoine Pauline Lemoine Marie Bruand Emmanuel Kammerer Emilie Bogart Pauline Comte Philippe Royer Juliette Thariat Juliette Thariat Juliette Thariat David Pasquier David Pasquier David Pasquier |
| author_facet | Pauline Lemoine Pauline Lemoine Marie Bruand Emmanuel Kammerer Emilie Bogart Pauline Comte Philippe Royer Juliette Thariat Juliette Thariat Juliette Thariat David Pasquier David Pasquier David Pasquier |
| author_sort | Pauline Lemoine |
| collection | DOAJ |
| description | IntroductionStereotactic radiotherapy may improve the prognosis of oligometastatic patients. In the literature, there is very little data available that is specific to breast cancer.Materials and MethodsWe conducted a multicenter retrospective study. The primary objective was to estimate progression-free survival after stereotactic body radiotherapy (SBRT) using Cyberknife of breast cancer oligometastases. The secondary objectives were to estimate overall survival, local control, and toxicity. The inclusion criteria were oligometastatic breast cancer with a maximum of five lesions distributed in one to three different organs, diagnosed on PET/CT and/or MRI, excluding brain metastases and oligoprogressions. This was combined with systemic medical treatment.FindingsForty-four patients were enrolled from 2007 to 2017, at three high-volume cancer centers. The patients mostly had one to two lesion(s) whose most widely represented site was bone (24 lesions or 44.4%), particularly in the spine, followed by liver (22 lesions or 40.7%), then pulmonary lesions (six lesions or 11.1%). The primary tumor expressed estrogen receptors in 33 patients (84.6%); the status was HER2+++ in 7 patients (17.9%). The median dose was 40 Gy (min-max: 15-54) prescribed at 80% isodose, the median number of sessions was three (min-max: 3-10). The median D50% was 42 Gy (min max 17-59). After a median follow-up of 3.4 years, progression-free survival (PFS) at one year, two years, and three years was 81% (95% CI: 66-90%), 58% (95% CI: 41-72%), and 45% (95% CI: 28-60%), respectively. The median PFS was 2.6 years (95% CI: 1.3 – 4.9). Overall survival at three years was 81% (95% CI: 63-90%). The local control rate at two and three years was 100%. Three patients (7.3%) experienced G2 acute toxicity, no grade ≥3 toxicity was reported.ConclusionThe PFS of oligometastatic breast cancer patients treated with SBRT appears long, with low toxicity. Local control is high. SBRT for oligometastases is rarely applied in breast cancer in light of the population in our study. Phase III studies are ongoing. |
| first_indexed | 2024-12-18T01:22:53Z |
| format | Article |
| id | doaj.art-9ceb9ebe30024d8fb06f41794022afba |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-18T01:22:53Z |
| publishDate | 2021-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-9ceb9ebe30024d8fb06f41794022afba2022-12-21T21:25:47ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2021-10-011110.3389/fonc.2021.736690736690Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter StudyPauline Lemoine0Pauline Lemoine1Marie Bruand2Emmanuel Kammerer3Emilie Bogart4Pauline Comte5Philippe Royer6Juliette Thariat7Juliette Thariat8Juliette Thariat9David Pasquier10David Pasquier11David Pasquier12Academic Department of Radiation Oncology, O. Lambret Center, Lille, FranceUniversity of Lille, H. Warembourg School of Medicine, Lille, FranceDepartment of Radiation Therapy, Lorraine Institute of Oncology, Nancy, FranceDepartment of Radiation Oncology, Centre Francois Baclesse, Caen, FranceBiostatistics department, Oscar Lambret Center, Lille, FranceDepartment of Medical Physics, O. Lambret Center, Lille, FranceDepartment of Radiation Therapy, Lorraine Institute of Oncology, Nancy, FranceDepartment of Radiation Oncology, Centre Francois Baclesse, Caen, FranceAdvanced Resource Centre for Hadrontherapy (ARCHADE Research Community), Caen, FranceLaboratory of High-Energy Particle Physics, Institut National de Physique Nucléaire et de Physique des Particules, The National Engineering School of Caen (IN2P3/ENSICAEN), CNRS UMR 6534—Normandy University, Caen, FranceAcademic Department of Radiation Oncology, O. Lambret Center, Lille, FranceUniversity of Lille, H. Warembourg School of Medicine, Lille, FranceCRIStAL (Centre de Recherche en Informatique, Signal et Automatique de Lille [Research center in Computer Science, Signal and Automatic Control of Lille] UMR 9189, Lille University, Lille, FranceIntroductionStereotactic radiotherapy may improve the prognosis of oligometastatic patients. In the literature, there is very little data available that is specific to breast cancer.Materials and MethodsWe conducted a multicenter retrospective study. The primary objective was to estimate progression-free survival after stereotactic body radiotherapy (SBRT) using Cyberknife of breast cancer oligometastases. The secondary objectives were to estimate overall survival, local control, and toxicity. The inclusion criteria were oligometastatic breast cancer with a maximum of five lesions distributed in one to three different organs, diagnosed on PET/CT and/or MRI, excluding brain metastases and oligoprogressions. This was combined with systemic medical treatment.FindingsForty-four patients were enrolled from 2007 to 2017, at three high-volume cancer centers. The patients mostly had one to two lesion(s) whose most widely represented site was bone (24 lesions or 44.4%), particularly in the spine, followed by liver (22 lesions or 40.7%), then pulmonary lesions (six lesions or 11.1%). The primary tumor expressed estrogen receptors in 33 patients (84.6%); the status was HER2+++ in 7 patients (17.9%). The median dose was 40 Gy (min-max: 15-54) prescribed at 80% isodose, the median number of sessions was three (min-max: 3-10). The median D50% was 42 Gy (min max 17-59). After a median follow-up of 3.4 years, progression-free survival (PFS) at one year, two years, and three years was 81% (95% CI: 66-90%), 58% (95% CI: 41-72%), and 45% (95% CI: 28-60%), respectively. The median PFS was 2.6 years (95% CI: 1.3 – 4.9). Overall survival at three years was 81% (95% CI: 63-90%). The local control rate at two and three years was 100%. Three patients (7.3%) experienced G2 acute toxicity, no grade ≥3 toxicity was reported.ConclusionThe PFS of oligometastatic breast cancer patients treated with SBRT appears long, with low toxicity. Local control is high. SBRT for oligometastases is rarely applied in breast cancer in light of the population in our study. Phase III studies are ongoing.https://www.frontiersin.org/articles/10.3389/fonc.2021.736690/fullbreast canceroligometastaticstereotactic body radiotherapy (SBRT)Metastasis-directed therapyprogression free survival |
| spellingShingle | Pauline Lemoine Pauline Lemoine Marie Bruand Emmanuel Kammerer Emilie Bogart Pauline Comte Philippe Royer Juliette Thariat Juliette Thariat Juliette Thariat David Pasquier David Pasquier David Pasquier Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study Frontiers in Oncology breast cancer oligometastatic stereotactic body radiotherapy (SBRT) Metastasis-directed therapy progression free survival |
| title | Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study |
| title_full | Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study |
| title_fullStr | Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study |
| title_full_unstemmed | Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study |
| title_short | Stereotactic Body Radiation Therapy for Oligometastatic Breast Cancer: A Retrospective Multicenter Study |
| title_sort | stereotactic body radiation therapy for oligometastatic breast cancer a retrospective multicenter study |
| topic | breast cancer oligometastatic stereotactic body radiotherapy (SBRT) Metastasis-directed therapy progression free survival |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2021.736690/full |
| work_keys_str_mv | AT paulinelemoine stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT paulinelemoine stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT mariebruand stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT emmanuelkammerer stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT emiliebogart stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT paulinecomte stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT philipperoyer stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT juliettethariat stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT juliettethariat stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT juliettethariat stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT davidpasquier stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT davidpasquier stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy AT davidpasquier stereotacticbodyradiationtherapyforoligometastaticbreastcanceraretrospectivemulticenterstudy |