Journal Article

DKFZ-2024-02760

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Metastasis-directed stereotactic radiotherapy in patients with breast cancer: results of an international multicenter cohort study.

Fabian, A. ; Buergy, D. ; Weykamp, F.DKFZ* ; Hörner-Rieber, J.DKFZ* ; Bernhardt, D. ; Boda-Heggemann, J. ; Pazos, M. ; Mehrhof, N. ; Kaul, D. ; Bicu, A. S. ; Badra, E. V. ; Rogers, S. ; Janssen, S. ; Hemmatazad, H. ; Hintelmann, K. ; Gkika, E. ; Lange, T. ; Ferentinos, K. ; Karle, H. ; Brunner, T. ; Wittig, A. ; Nona-Duma, M. ; Blanck, O. ; Krug, D.

2025
Springer Science + Business Media B.V. Dordrecht

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Please use a persistent id in citations: doi:10.1007/s10585-024-10326-x

Abstract: Metastasis-directed therapy (MDT) for oligometastatic breast cancer (≤ 5 metastases) has shown little effect in specific scenarios of randomized trials. Therefore, we aimed to assess outcomes after metastasis-directed stereotactic radiotherapy (SRT) in various clinical scenarios. We conducted an international retrospective cohort study in thirteen centers including breast cancer patients receiving SRT to any metastatic site. Outcomes included local recurrence (LR), progression-free survival (PFS), and overall survival (OS). Cumulative incidence analysis was used for LR, Kaplan-Meier estimates for PFS and OS. Covariables included patient, disease, and SRT characteristics. We performed univariable and multivariable analyses (MVA). Among 444 patients, 751 metastases were treated with SRT. Of these, 73% were intracranial and 27% extracranial lesions. Oligometastatic disease (OMD) was present in 66% of the patients. LR after two years occurred significantly more often in intracranial (25%) versus extracranial lesions (7%). In MVA of patients with OMD treated for intracranial sites, higher performance status was significantly associated with longer PFS. Further, higher performance status, biologic subtype (HR-pos./HER2-pos.), and MDT to all sites were significantly associated with longer OS. In MVA of oligometastatic patients treated for extracranial sites, biologic subtype (HR-neg./HER2-pos.) and synchronous metastasis were associated with significantly longer PFS, whereas higher grading was associated with significantly shorter PFS. Moreover, biologic subtype (HR-neg./HER2-neg.) was associated with significantly shorter OS. In conclusion, the role of MDT for breast cancer may vary per clinical scenario. Patients with OMD treated for intracranial lesions who had MDT to all sites showed superior OS. Our results should be validated prospectively.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Breast Neoplasms: pathology (MeSH) ; Breast Neoplasms: radiotherapy (MeSH) ; Breast Neoplasms: mortality (MeSH) ; Breast Neoplasms: surgery (MeSH) ; Retrospective Studies (MeSH) ; Radiosurgery: methods (MeSH) ; Middle Aged (MeSH) ; Aged (MeSH) ; Adult (MeSH) ; Neoplasm Recurrence, Local: pathology (MeSH) ; Neoplasm Recurrence, Local: radiotherapy (MeSH) ; Brain Neoplasms: secondary (MeSH) ; Brain Neoplasms: radiotherapy (MeSH) ; Brain Neoplasms: surgery (MeSH) ; Aged, 80 and over (MeSH) ; Neoplasm Metastasis (MeSH) ; Brain metastases ; Breast cancer ; Metastasis ; Oligometastasic disease ; Stereotactic radiotherapy

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Contributing Institute(s):

1. E050 KKE Strahlentherapie (E050)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2024

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Springer ; DEAL Springer ; Essential Science Indicators ; IF < 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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