Survival outcomes and toxicity profile after CT-guided HDR brachytherapy (interventional radiotherapy) for liver oligometastases in breast cancer patients: The BRALIBREST real world multicenter study.
Bilski M, Kuncman Ł, Orzechowska M, Cisek P, Mastroleo F, Skrzypczak M, Sroka S, Wojtyna E, Ferentinos K, Hering K, Fijuth J, Jereczek-Fossa BA, Ha HM, Medenwald D, Fabritius MP, Corradini S, Seidensticker M, Ricke J, Pech M, Fuchs F, Rogowski P (2026)
Publication Type: Journal article
Publication year: 2026
Journal
Book Volume: 214
DOI: 10.1016/j.radonc.2025.111280
Abstract
OBJECTIVE: To evaluate efficacy and tolerability of high-dose-rate brachytherapy (HDR-BT) for breast-cancer (BC) liver oligometastases. STUDY DESIGN: We included patients with oligometastatic breast cancer, defined as having ≤ 5 liver metastases, WHO performance status <3, tumor diameter <10 cm. Patients were excluded if tumor location prevented applicator placement or adequate dosing of CT-guided HDR-BT. End-points were overall survival (OS), progression-free survival (PFS), locoregional control (LRC), modified PFS (mPFS), freedom from subsequent systemic-therapy line and radiological response - disease control rate and objective response rate (ORR). Univariate (UVA) and multivariate (MVA) Cox models explored clinicopathologic and dosimetric predictors. RESULTS: A total of 107 patients were included; 61 % were treated for a single lesion, and 39 % for multiple. The median prescribed dose was 20 Gy (15-25 Gy). The median OS was 37 months (2-year: 60 %). Median PFS, LRC, mPFS, and freedom from subsequent systemic-therapy were 13, 19, 15, and 22 months. Disease control rate improved from 93 % at 6 months to 98 % at 12, while ORR rose from 63 % to 85 %. On UVA, repeat and induced oligometastatic disease predicted superior OS, while extrahepatic spread, liver volume >10 cm3, and lesion diameter >4 cm were adverse. Delivering ≥25 Gy to 90 % of GTV halved the risk of death. Only grade 1-2 acute toxicities were observed; no grade ≥3 events, with 8 % late grade 3 hepatic toxicity. CONCLUSION: HDR-BT appears to be an effective metastasis-directed therapy for selected patients with BC liver oligometastases.
Involved external institutions
Medical University of Lublin / Uniwersytet Medyczny w Lublinie
Poland (PL)
Medical University of Łódź / Uniwersytet Medyczny w Łodzi
Poland (PL)
NU-MED Center for Diagnostics and Oncology Therapy Zamość Sp. z o.o.
Poland (PL)
European Institute of Oncology / Istituto Europeo di Oncologia (IEO)
Italy (IT)
St. John's Cancer Center Lublin
Poland (PL)
European University Cyprus (EUC) / Ευρωπαϊκό Πανεπιστήμιο Κύπρου
Cyprus (CY)
Universitätsklinikum Leipzig
Germany (DE)
Universitätsklinikum Magdeburg A.ö.R.
Germany (DE)
Klinikum der Universität München (LMU Klinikum)
Germany (DE)
Poland (PL)
Medical University of Łódź / Uniwersytet Medyczny w Łodzi
Poland (PL)
NU-MED Center for Diagnostics and Oncology Therapy Zamość Sp. z o.o.
Poland (PL)
European Institute of Oncology / Istituto Europeo di Oncologia (IEO)
Italy (IT)
St. John's Cancer Center Lublin
Poland (PL)
European University Cyprus (EUC) / Ευρωπαϊκό Πανεπιστήμιο Κύπρου
Cyprus (CY)
Universitätsklinikum Leipzig
Germany (DE)
Universitätsklinikum Magdeburg A.ö.R.
Germany (DE)
Klinikum der Universität München (LMU Klinikum)
Germany (DE)
How to cite
APA:
Bilski, M., Kuncman, Ł., Orzechowska, M., Cisek, P., Mastroleo, F., Skrzypczak, M.,... Rogowski, P. (2026). Survival outcomes and toxicity profile after CT-guided HDR brachytherapy (interventional radiotherapy) for liver oligometastases in breast cancer patients: The BRALIBREST real world multicenter study. Radiotherapy and Oncology, 214. https://doi.org/10.1016/j.radonc.2025.111280
MLA:
Bilski, Mateusz, et al. "Survival outcomes and toxicity profile after CT-guided HDR brachytherapy (interventional radiotherapy) for liver oligometastases in breast cancer patients: The BRALIBREST real world multicenter study." Radiotherapy and Oncology 214 (2026).
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