Stereotactic body radiotherapy to treat breast cancer oligometastases: A systematic review with meta-analysis.

Autor: Viani GA; Ribeirão Preto Medical School, Department of Medical Imagings, Hematology and Oncology of University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil; Latin America Cooperative Oncology Group (LACOG), Porto Alegre, Brazil. Electronic address: fydm@queensu.ca., Gouveia AG; Latin America Cooperative Oncology Group (LACOG), Porto Alegre, Brazil; Radiation Oncology Department - Americas Centro de Oncologia Integrado, Rio de Janeiro, Brazil., Louie AV; Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada., Korzeniowski M; Department of Oncology - Division of Radiation Oncology, Kingston General Hospital, Queen's University, Kingston, Canada., Pavoni JF; Faculty of Philosophy, Letters and Natural Sciences, University of São Paulo, Ribeirão Preto, Brazil., Hamamura AC; Ribeirão Preto Medical School, Department of Medical Imagings, Hematology and Oncology of University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil., Moraes FY; Latin America Cooperative Oncology Group (LACOG), Porto Alegre, Brazil; Department of Oncology - Division of Radiation Oncology, Kingston General Hospital, Queen's University, Kingston, Canada.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2021 Nov; Vol. 164, pp. 245-250. Date of Electronic Publication: 2021 Oct 06.
DOI: 10.1016/j.radonc.2021.09.031
Abstrakt: Objectives: Stereotactic ablative radiotherapy (SABR) has been reported to be an effective treatment for oligometastatic disease from different primary cancer sites. Here we assess the effectiveness and safety of SABR for oligometastatic breast cancer patients by performing a meta-analysis.
Methods: Following PRISMA and MOOSE guidelines, a systematic review and meta-analysis was performed. Eligible studies were identified on Medline, Embase, Cochrane Library, and annual meetings proceedings from 1990 to June 2021. A meta-regression analysis was performed to assess if there was a correlation between moderator variables and outcomes, and a p-value <0.05 was considered significant.
Results: Ten studies met criteria for inclusion, comprising 467 patients and 653 treated metastases. The 1- and 2-year local control rates were 97% (95% CI 95-99%), and 90% (95% CI 84-94%), respectively. Overall survival (OS) was 93% (95% CI 89-96%) at 1 year, 81% (95% CI 72-88%) at 2 years. The rate of any grade 2 or 3 toxicity was 4.1 % (95% CI 0.1-5%), and 0.7% (0-1%), respectively. In the meta-regression analysis, only prospective design (p = 0.001) and bone-only metastases (p = 0.01) were significantly associated with better OS. In the subgroup analysis, the OS at 2y were significantly different comparing HER2+, HR+/HER2(-) and triple negative breast cancer 100%, 86% and 32%, p = 0.001. For local control outcomes, hormone receptor status (p = 0.01) was significantly associated on meta-regression analysis.
Conclusion: SABR for oligometastatic breast cancer is safe and associated with high rates of local control. Longer follow-up of existing data and ongoing prospective trials will help further define the role of this management strategy.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: