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Advances in breast cancer treatment: a systematic review of preoperative stereotactic body radiotherapy (SBRT) for breast cancer.
Bilski, Mateusz; Konat-Baska, Katarzyna; Zerella, Maria Alessia; Corradini, Stefanie; Hetnal, Marcin; Leonardi, Maria Cristina; Gruba, Martyna; Grzywacz, Aleksandra; Hatala, Patrycja; Jereczek-Fossa, Barbara Alicja; Fijuth, Jacek; Kuncman, Lukasz.
Afiliação
  • Bilski M; Department of Radiotherapy, Medical University of Lublin, Lublin, Poland.
  • Konat-Baska K; Department of Brachytherapy, Lublin Cancer Center, Lublin, Poland.
  • Zerella MA; Department of Radiotherapy, Lublin Cancer Center, Lublin, Poland.
  • Corradini S; Department of Brachytherapy, Lower Silesian Oncology Pulmonology and Hematology Center, Wroclaw, Poland.
  • Hetnal M; Department of Radiation Oncology, European Institute of Oncology IRCCS, 20141, Milan, Italy.
  • Leonardi MC; Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany.
  • Gruba M; Department of Oncology, Faculty of Medicine, Andrzej Frycz Modrzewski Krakow University, Kraków, Poland.
  • Grzywacz A; Amethyst Radiotherapy Centre, Ludwik Rydygier Memorial Hospital, Kraków, Poland.
  • Hatala P; Department of Radiation Oncology, European Institute of Oncology IRCCS, 20141, Milan, Italy.
  • Jereczek-Fossa BA; Department of Radiotherapy, Medical University of Lublin, Lublin, Poland.
  • Fijuth J; Department of Radiotherapy, Medical University of Lublin, Lublin, Poland.
  • Kuncman L; Department of Radiotherapy, Medical University of Lublin, Lublin, Poland.
Radiat Oncol ; 19(1): 103, 2024 Aug 02.
Article em En | MEDLINE | ID: mdl-39095859
ABSTRACT
Breast conserving treatment typically involves surgical excision of tumor and adjuvant radiotherapy targeting the breast area or tumor bed. Accurately defining the tumor bed is challenging and lead to irradiation of greater volume of healthy tissues. Preoperative stereotactic body radiotherapy (SBRT) which target tumor may solves that issues. We conducted a systematic literature review to evaluates the early toxicity and cosmetic outcomes of this promising treatment approach. Secondary we reviewed pathological complete response (pCR) rates, late toxicity, patient selection criteria and radiotherapy protocols. We retrieved literature from PubMed, Scopus, Web of Science, Cochrane, ScienceDirect, and ClinicalTrials.gov. The study adhered to the PRISMA 2020 guidelines. Ten prospective clinical trials (7 phase II, 3 phase I), encompassing 188 patients (aged 18-75 years, cT1-T3 cN0-N3 cM0, primarily with ER/PgR-positive, HER2-negative status,), were analyzed. Median follow-up was 15 months (range 3-30). Treatment involved single-fraction SBRT (15-21Gy) in five studies and fractionated (19.5-31.5Gy in 3 fractions) in the rest. Time interval from SBRT to surgery was 9.5 weeks (range 1-28). Acute and late G2 toxicity occurred in 0-17% and 0-19% of patients, respectively, G3 toxicity was rarely observed. The cosmetic outcome was excellent in 85-100%, fair in 0-10% and poor in only 1 patient. pCR varied, showing higher rates (up to 42%) with longer intervals between SBRT and surgery and when combined with neoadjuvant systemic therapy (up to 90%). Preoperative SBRT significantly reduce overall treatment time, enabling to minimalize volumes. Early results indicate excellent cosmetic effects and low toxicity.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Radiocirurgia Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Radiocirurgia Idioma: En Ano de publicação: 2024 Tipo de documento: Article