Breast radiotherapy as part of loco-regional treatments in stage IV breast cancer patients with oligometastatic disease

Bourgier, Céline; Khodari, Wassim; Vataire, Anne-Lise; Pessoa, Eduardo Lima; Dunant, Ariane; Delaloge, Suzette; Uzan, Catherine; Balleyguier, Corinne; Mathieu, Marie-Christine; Marsiglia, Hugo; Arriagada, Rodrigo

doi:10.1016/j.radonc.2010.02.028

« Previous Next »Radiotherapy & Oncology
Volume 96, Issue 2 , Pages 199-203, August 2010

Breast radiotherapy as part of loco-regional treatments in stage IV breast cancer patients with oligometastatic disease☆

Céline Bourgier
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
- Corresponding author at: Département de Radiothérapie, Institut Gustave Roussy, 39 rue Camille Desmoulins, 94 800 Villejuif, France.
Wassim Khodari
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
Anne-Lise Vataire
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
Eduardo Lima Pessoa
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
Ariane Dunant
- Biostatistics and Epidemiology Unit, Institut Gustave Roussy, Villejuif, France
Suzette Delaloge
- Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France
Catherine Uzan
- Department of Breast Surgery, Institut Gustave Roussy, Villejuif, France
Corinne Balleyguier
- Department of Radiology, Institut Gustave Roussy, Villejuif, France
Marie-Christine Mathieu
- Department of Pathology, Institut Gustave Roussy, Villejuif, France
Hugo Marsiglia
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
- University of Florence, Italy
Rodrigo Arriagada
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
- Department of Oncology, Karolinska Institutet, Stockholm, Sweden

Received 18 August 2009; received in revised form 12 February 2010; accepted 23 February 2010. published online 29 March 2010.

Abstract

Background

Local treatments seem to improve metastasis progression-free survival (MPFS) and overall survival (OS) when added to systemic therapies in stage IV breast cancer.

Methods

From 1990 to 2003, we reviewed 9138 cases treated and registered in the Institut Gustave-Roussy breast cancer database. Among them, 308 had presented with stage IV disease. Eighty percent of patients (n=239) had received a loco-regional treatment and they were categorized into two groups: loco-regional radiotherapy (LRRT) alone (Group 1; n=147) or breast and axillary surgery±LRRT (Group 2; n=92).

Results

The median follow-up was 6.5years. LRRT obtained a long-standing loco-regional clinical response in 85% of patients. The 3-year MPFS rates were 20% in Group 1 and 39% in Group 2; the 3-year OS rates were 39% and 57%, respectively. However, no significant differences in MPFS or OS were observed between the two groups when adjusted on prognostic factors.

Conclusions

Radiation therapy alone provides long-standing local control and yields MPFS and OS rates equivalent to those obtained when radiation therapy is combined with surgery, whatever the prognostic factors. Loco-regional therapies, especially radiation therapy alone, may have an important role to play in the treatment of selected patients with stage IV breast cancer.

Keywords: Breast cancer, Oligometastases, Radiotherapy