Radiation Oncology/Breast/Metastatic

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Metastatic Breast Cancer

[edit] Local Control

Hawaii; 2009 PMID 19876731 -- "Loco-regional treatment in metastatic breast cancer patients: Is there a survival benefit?" (Ly BH, Breast Cancer Res Treat. 2009 Oct 30. [Epub ahead of print])
- Literature review. 13 studies evaluating loco-regional treatment (surgery, or surgery + RT, RT)
- Outcome: Median OS no surgery 12-28 months vs. surgery 25-42 months; 3-year OS 17-79% vs. 28-95%
- Conclusion: Possibility of surgery and/or RT following induction should be left to individual practice

Turkey (2003-2005) -- Zoledronic acid + RT 30/10 vs. Zoledronic acid + RT 15/5
- Randomized. 100 patients, at least one bone metastasis, life expectancy >6 months. Excluded pathologic fractures, prior RT to that area, prior treatment with zoledronic acid, brain mets. Zoledronic acid 4 mg Q28 days, starting day 1 of RT. Used objective measure (MRI, bone scan) and subjective end points (pain, analgesic score, visual analog score)
- 2009 PMID 19484483 -- "Zoledronic acid concurrent with either high- or reduced-dose palliative radiotherapy in the management of the breast cancer patients with bone metastases: a phase IV randomized clinical study." (Atahan L, Support Care Cancer. 2009 May 31. [Epub ahead of print]). Minimum F/U 6 months
  - Outcome: No difference in time-to-first skeletal event, rate of first-skeleta-event, time-to-response, rate of response, or duration of response. Higher satisfaction in shorter 15/5 arm
  - Conclusion: Concomitant use of zoledronic acid and RT safe