Long-term disease control and survival observed after stereotactic ablative body radiotherapy for oligometastatic breast cancer Journal Article
| Authors: | Wijetunga, N. A.; dos Anjos, C. H.; Zhi, W. I.; Robson, M.; Tsai, C. J.; Yamada, Y.; Dover, L.; Gillespie, E. F.; Xu, A. J.; Yang, J. T. |
| Article Title: | Long-term disease control and survival observed after stereotactic ablative body radiotherapy for oligometastatic breast cancer |
| Abstract: | Purpose: We examined the characteristics of breast cancer patients with oligometastases (OM) treated with stereotactic ablative body radiotherapy (SABR) to identify factors associated with local progression, distant metastasis progression, time to subsequent therapy, progression-free survival (PFS), and overall survival (OS). Methods: We retrospectively reviewed a single-institution database of patients treated with radiotherapy between 2008 and 2018 and identified 79 patients who received SABR to OM. Twenty-seven patients had genetic testing of metastatic tumors using an institutional targeted sequencing platform. Kaplan–Meier analysis, Cox regression, and competing risk models were used to compare clinical and genetic correlates with outcomes. Results: Median follow-up was 50 months (IQR: 29–66) with 67% of patients alive at the last follow-up. Of the 65% of patients who progressed, 82% progressed outside of the radiation field, 18% experienced local failure, and 80% had oligoprogression. Median OS was 86 months (IQR: 29–66), and PFS was 33 months (IQR: 10–38). Less than 5 years from diagnosis to SABR and triple-negative breast cancer (TNBC) were associated with worse OS. Advanced T stage, any prior chemotherapy, and TNBC were associated with worse PFS. Alterations in CEBPB, RB1, TBX3, PTEN, and CDK4 were associated with worse survival outcomes. Conclusion: Long-term systemic disease control and survival can be achieved with SABR for oligometastatic breast cancer. Hormone receptor-positive patients with a long disease interval from initial diagnosis and limited systemic progression history may be ideal for SABR to all sites of disease. © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. |
| Keywords: | adult; cancer chemotherapy; cancer survival; controlled study; aged; treatment failure; unclassified drug; major clinical study; overall survival; clinical feature; cancer growth; patient selection; bone metastasis; cancer patient; cancer staging; outcome assessment; follow up; lymph node metastasis; antineoplastic agent; genetic analysis; protein analysis; disease association; metastasis; progression free survival; breast cancer; cohort analysis; transcription factor; medical record review; retrospective study; distant metastasis; survival time; liver metastasis; lung metastasis; phosphatidylinositol 3,4,5 trisphosphate 3 phosphatase; brain metastasis; long term care; radiation therapy; cancer control; stereotactic body radiation therapy; retinoblastoma protein; radiation field; cyclin dependent kinase 4; soft tissue metastasis; ccaat enhancer binding protein beta; triple negative breast cancer; time to treatment; oligometastases; human; male; female; article; transcription factor tbx3; oncogenomics; women's cancer; retinoblastoma 1 protein; oligometastatic breast cancer |
| Journal Title: | Cancer Medicine |
| Volume: | 10 |
| Issue: | 15 |
| ISSN: | 2045-7634 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2021-08-01 |
| Start Page: | 5163 |
| End Page: | 5174 |
| Language: | English |
| DOI: | 10.1002/cam4.4068 |
| PUBMED: | 34159748 |
| PROVIDER: | scopus |
| PMCID: | PMC8335830 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 September 2021 -- Source: Scopus |
