Abstract
BackgroundFew studies of proton beam therapy (PBT) for patients with liver metastasis from breast cancer (LMBC) are available to date. The aim of the present study was to evaluate the clinical effectiveness of PBT for patients with LMBC.Material and MethodsSeventeen patients with LMBC treated with PBT were included in this study. The median prescribed dose of PBT was 66 GyE (range, 60–80) in 10 fractions, 5 times a week. In patients with LMBC receiving PBT, freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) rates were assessed.ResultsThe median follow-up time was 34.2 months (range, 11.5–56.1). The median FFLP time was not yet reached, and the 3-year FFLP rates were 94.1% (95% confidence interval [CI], 82.9–105.3). The median times of PFS and OS were 7.9 months (95% CI, 5.3–10.5) and 39.3 months (95% CI, 33.2–51.9), respectively, and the 3-year PFS and OS rates were 19.6% (95% CI, -1.8–41.0) and 71.7% (95% CI, 46.8–96.6), respectively. Grade 3 or higher adverse events were not observed.ConclusionPBT for patients with LMBC showed promising FFLP and OS with safe toxicity profiles. These findings suggest that PBT can be considered a local treatment option in patients with LMBC.
Highlights
Patients with liver metastases from breast cancer (LMBC), considered a manifestation of incurable systemic disease, have a poor prognosis of 4–8 months’ survival, if untreated, and 18-24 months, even with systemic chemotherapy and/or hormonal treatments [1]
Most patients with LMBC remain ineligible for hepatic resection, which has raised the need for other local treatments, such as radiofrequency ablation (RFA), cryoablation, transarterial chemoembolization (TACE), transarterial radioembolization (TARE), stereotactic body radiotherapy (SBRT), and proton beam therapy (PBT) [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27]
Compared with conventional fractionated radiotherapy, hypofractionated radiotherapy has potential theoretical and practical advantages in terms of improvement of the therapeutic ratio by reducing cancer cell proliferation in involved tissues within the tolerance of surrounding uninvolved normal tissues and minimizing the delay or interruption of systemic treatments by shortening the overall duration of radiotherapy. Based on this background, hypofractionated PBT with various sequences and/or regimens of systemic treatments depending on the response to systemic treatments to LMBC and/or extrahepatic disease has been applied for patients with LMBC in our institution
Summary
Patients with liver metastases from breast cancer (LMBC), considered a manifestation of incurable systemic disease, have a poor prognosis of 4–8 months’ survival, if untreated, and 18-24 months, even with systemic chemotherapy and/or hormonal treatments [1]. Compared with conventional fractionated radiotherapy, hypofractionated radiotherapy has potential theoretical and practical advantages in terms of improvement of the therapeutic ratio by reducing cancer cell proliferation in involved tissues within the tolerance of surrounding uninvolved normal tissues and minimizing the delay or interruption of systemic treatments by shortening the overall duration of radiotherapy. Based on this background, hypofractionated PBT with various sequences and/or regimens of systemic treatments depending on the response to systemic treatments to LMBC and/or extrahepatic disease has been applied for patients with LMBC in our institution.
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