Local treatment in oligometastasis from breast cancer: an overview.

Oligometastasic breast cancer (OMBC) consists of breast cancer patient with a limited number of systemic metastases (≤ 5), all of them candidates for local ablative treatment with the intention of achieving long-term control of the metastasis and, eventually, an increase in survival The first consensus for the management of patients with oligometastatic breast cancer (OMBC) was published in 2007, establishing that a more aggressive multidisciplinary strategy is recommended in order to increase the survival while maintaining a good quality of life. The current scientific evidence is based on observational studies, mainly retrospective, systematic reviews and meta-analyses, and only a randomized nonexclusive study of oligometastatic (OM) published. All trials with Stereotactic Body Radiation Therapy (SBRT) in OM cancer have shown excellent tolerance and good local control, although first trials on Lung SBRT did not prove so excellent tolerance and had some deaths due to bronchus irradiation and secondary hemoptysis. There are multiple ongoing studies researching the benefit of SBRT in oligometastatic breast cancer. Despite the lack of impact on survival seen in the NRG BR-002 Trial, SBRT probably allows the delay of the systemic treatment until progression, and so, improves the quality of life of patients. We have to wait for the results of the ongoing and future studies for clarification of the role of local treatment in OMBC.

Adjuvant radiotherapy in malignant tumors of parotid. Experience of the Navarra Hospital Complex.

BACKGROUND: The objective of the study was to review the outcome of patients with parotid cancer treated with postoperative radiotherapy at Complejo Hospitalario de Navarra in the last ten years. MATERIALS AND METHODS: We retrospectively reviewed patients treated with adjuvant radiotherapy between January 2008 and December 2018. We analyzed demographic data, histopathologic findings, local control (LC) and overall survival (OS). RESULTS: A total of 40 patients received postoperative radiotherapy during the period mentioned. There were 22 men (55%) and 18 women (45%). Median age was 58 years (19-90). By tumor histology, the most common was squamous cell carcinoma (22.5%) followed by ex-pleomorphic adenoma (15%) and adenoid cystic carcinoma (10%). According to Surgery, 19 patients (47.5%) underwent a total parotidectomy, 20 (50%) partial parotidectomy, and 1 (2.5%) a radical parotidectomy. Twenty-one patients (51.2%) underwent cervical dissection, most of them being supraomohyoid (31.7%). Reasons for adjuvant RT were: R1 resection (35% of the patients), high grade tumors (27.5%) and 17.5% because R1 surgery and R1. Radiation was administered using IMRT in most patients to a total dose of 60 Gy in 30 fractions. The 5-year overall survival (OS) (Kaplan-Meier) was 81% (95% CI: 68.5-96.2%), and 10-years - 64%. The 5-year local control (LC) (Kaplan-Meier) was 82.4% (95% CI: 91.46-73.33%) and the 10-year LC - 72.2% (95% CI: 54.9-96%). To date, only 4 patients (10%) have died due to their parotid tumor. CONCLUSION: The adjuvant radiotherapy added to surgery, significantly reduces the risk of recurrence in high-risk patients with a very acceptable survival rate.