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World J Clin Oncol. Jan 24, 2022; 13(1): 39-48
Published online Jan 24, 2022. doi: 10.5306/wjco.v13.i1.39
Role of radiotherapy in oligometastatic breast cancer: Review of the literature
Caglayan Selenge Beduk Esen, Melis Gultekin, Ferah Yildiz
Caglayan Selenge Beduk Esen, Melis Gultekin, Ferah Yildiz, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Ankara 06100, Turkey
Author contributions: Beduk Esen CS wrote the main body of the manuscript; Gultekin M and Yildiz F provided guidance in the structure of the manuscript and reviewed the manuscript.
Conflict-of-interest statement: The authors have no conflict of interests to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Caglayan Selenge Beduk Esen, MD, Research Scientist, Department of Radiation Oncology, Hacettepe University Faculty of Medicine, Sıhhiye, Ankara 06100, Turkey. selengebedk@gmail.com
Received: February 28, 2021
Peer-review started: February 28, 2021
First decision: April 27, 2021
Revised: May 5, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 24, 2022
Processing time: 327 Days and 19.2 Hours
Abstract

Metastatic breast cancer has been historically considered as an incurable disease. Radiotherapy (RT) has been traditionally used for only palliation of the symptoms caused by metastatic lesions. However, in recent years the concept of oligometastatic disease has been introduced in Cancer Medicine as a clinical scenario with a limited number of metastases (≤ 5) and involved organs (≤ 2) with controlled primary tumor. The main hypothesis in oligometastatic disease is that locoregional treatment of primary tumor site and metastasis-directed therapies with surgery and/or RT may improve outcomes. Recent studies have shown that not all metastatic breast cancer patients have the same prognosis, and selected patients with good prognostic features as those younger than 55 years, hormone receptor-positive, limited bone or liver metastases, a low-grade tumor, good performance status, long disease-free interval (> 12 mo), and good response to systemic therapy may provide maximum benefit from definitive treatment procedures to all disease sites. While retrospective and prospective studies on locoregional treatment in oligometastatic breast cancer demonstrated conflicting results, there is an increasing trend in favor of locoregional treatment. Currently, available data also demonstrated the improvements in survival with metastasis-directed therapy in oligometastatic breast cancer. The current review will discuss the concept of oligometastases and provide up-to-date information about the role of RT in oligometastatic breast cancer.

Keywords: Breast cancer; Oligometastatic; Radiotherapy; Locoregional treatment; Ablative therapy; Metastasis-directed therapy

Core Tip: Radiotherapy (RT) has been traditionally used for only palliation of the symptoms caused by metastatic lesions. However, in recent years the concept of oligometastatic disease has been introduced in Cancer Medicine as a clinical scenario with a limited number of metastases (≤ 5) and involved organs (≤ 2) with controlled primary tumor. The main hypothesis in oligometastatic disease is that locoregional treatment of primary tumor site and metastasis-directed therapies with surgery and/or RT may improve outcomes. The current review will provide up-to-date information about the role of RT in oligometastatic breast cancer.