Radiation therapy for bone-only metastases in breast cancer patients: A GOCO survey of current clinical practice

Rep Pract Oncol Radiother. 2020 Jan-Feb;25(1):113-116. doi: 10.1016/j.rpor.2019.12.019. Epub 2019 Dec 20.

Abstract

Introduction: The role of radiation therapy (RT) for patients with bone-only metastatic (BOM) breast cancer has not been investigated sufficiently. The aim of this survey was to evaluate current clinical practice in treating breast cancer patients with BOM in Radiation Therapy Departments in Catalonia and Occitania within the scope of the GOCO group.

Materials and methods: An electronic questionnaire was completed by experienced radiation oncologists from fourteen RT centers. The items surveyed the professional experience, therapeutic approach, technique, dose stereotactic body RT (SBRT) availability.

Results: All Radiation Oncology Departments (ROD) in Catalonia (12) and Occitania (2) responded to the survey. Eleven (78.5%) of the RODs advise RT for BOM as initial treatment in the oligometastatic setting. RT to asymptomatic bone oligometastases is more often restricted for "risky lesions". The most inconsistent approaches were the treatment for asymptomatic lesions, when to treat bone metastases with respect to systemic treatment (ST) and the indication for RT after a complete response to ST.

Conclusion: While BOM breast cancer patients have a relatively good prognosis, there is a lack of consistency in their approach with RT. This can be explained by the absence of evidence-based guidelines and an incomplete availability of SBRT.

Keywords: Bone metastases; Breast cancer; Oligometastases; Radiation therapy; SBRT.