¿Se puede rescatar con irradiación la paciente con cáncer de mama oligometástasica?

Abstract

Improvements in our understanding of the biology of cancer have led to significant advancements in the diagnóstico and treatment of metastatic breast cancer. However, it is generally considered incurable. Currently, the European and American Societies for Radiation Therapy define oligometastatic disease as the presence of 1–5 treatable metastatic lesions. Although oligometastatic breast cancer has a more favorable prognosis than more advanced stages, there remains a significant challenge in identifying which patients would benefit most from radical treatment and defining the optimal therapeutic approach and sequence. Accurate diagnóstico of oligometastatic disease offers the possibility of administering ablative treatments such as Stereotactic Body Radiation Therapy (SBRT) or surgery, which could improve the prognosis of these patients. On the other hand, oligoprogression is a more recent concept that describes progression in a few sites in patients with globally controlled metastatic disease. Ablative treatment with SBRT allows for continued systemic treatment in these selected patients and results in greater long-term disease control and survival in multiple studies of patients with oligometastatic breast cancer. This approach represents a paradigm shift in the integration of these ablative techniques with systemic therapies, with the aim of improving the prognosis and quality of life of patients. The integration of new systemic agents with SBRT also generates debate about the optimal sequence of treatment and is therefore another topic of discussion.