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Hypo-fractionated ablative liver radiotherapy is a safe and well-tolerated modality for treating metastatic breast cancer, with excellent local control.

Metastasis in breast cancer frequently involves the lungs, bones, and liver. Advancement in the field of radiologic imaging has allowed for the identification of limited metastatic disease in cancer patients. This retrospective cohort described hypo-fractionated liver radiotherapy (RT) treatment outcomes in metastatic breast cancer (MBCa) patients. The findings are published in the journal Cancers.

Baseline Characteristics

The retrospective review included 30 MBCa patients with liver metastasis receiving 5–10 fraction RT. The median age of the study participants was 55.6 years.

Hypo-Fractionated Liver Radiotherapy Treatment Outcomes

The median follow-up duration was 14.6 months, and 100% local control of the metastatic lesions following the treatment was observed at one year, with the exception of one patient with local failure. MBCa disease progressed to other distant and regional areas in up to half of the  patients. In such patients, the most common indication for hypo-fractionated liver RT was oligo-progression.

Systemic Therapy in Metastatic Breast Cancer

All the patients included in the study, except for one, received systemic therapy spanning from the initial diagnosis to the administration of hypo-fractionated ablative liver RT. After liver RT, 56% of the patients were switched to second-line systemic therapy.

Toxicities Associated with Hypo-Fractionated Liver Radiotherapy

Approximately 66% of patients reported acute grade 1/2 toxicities, which included fatigue and nausea. One patient experienced an acute gastric ulcer of grade 3, per the National Cancer Institute-Common Terminology Criteria for Adverse Events scoring system, with an initial presentation of hematemesis.

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The study concluded that hypo-fractionated ablative liver RT is a well-tolerated and safe procedure for the treatment of MBCa. This modality has remarkable local control. 

Source

Mushonga, M., Helou, J., Weiss, J., Dawson, L. A., Wong, R. K. S., Hosni, A., Kim, J., Brierley, J., Koch, C. A., Alrabiah, K., Lindsay, P., Stanescu, T., & Barry, A. (2023). Clinical Outcomes of Patients with Metastatic Breast Cancer Treated with Hypo-Fractionated Liver Radiotherapy. Cancers, 15(10), 2839. https://doi.org/10.3390/cancers15102839