Stereotactic body radiotherapy to treat breast cancer oligometastases: A systematic review with meta-analysis
| Autor: | Juliana Fernandes Pavoni, Alexander V. Louie, Gustavo Arruda Viani, Andre G. Gouveia, Martin Korzeniowski, Fabio Y. Moraes, Ana Carolina Hamamura |
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| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty medicine.medical_treatment MEDLINE Bone Neoplasms Breast Neoplasms Subgroup analysis Cochrane Library Radiosurgery SABR volatility model Breast cancer Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Triple-negative breast cancer business.industry Hematology medicine.disease Radiation therapy Treatment Outcome RESULTADO DE TRATAMENTO Meta-analysis Female business |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2021.09.031 |
| Popis: | 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 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. |
| Databáze: | OpenAIRE |
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