局部消融治疗（LAT）在少量转移性乳腺癌（OMBC）中越来越多地与全身疗法结合使用，但缺乏高水平证据支持该策略。我们评估了在系统治疗中添加LAT对无进展生存期（PFS）和总生存期（OS）的影响。次要终点是局部控制（LC）和毒性。我们试图确定与较长OS和PFS相关的预后因素。我们确定了2014年至2018年接受同步或间歇性OMBC（定义为≤5个转移）治疗的连续患者。LAT包括立体定向体放射治疗（SBRT）和容积调制弧治疗（VMAT）、手术、冷冻治疗和经皮射频消融（PRA）。计算了PFS和OS，并对生存率的潜在预测因素进行了Cox回归模型分析。共包括102名患者（无LAT，n=62; LAT，n=40）。64个转移接受了LAT治疗。中位随访时间为50.4个月（95％CI [44.4; 53.4]）。LAT组有一名患者出现3级毒性。5年的PFS和OS分别为34.75％（95％CI [24.42-45.26]）和63.21％（95％CI [50.69-73.37]）。同时接受LAT和全身治疗的患者的PFS和OS要比不接受LAT的患者长（[HR 0.39，p=0.002]）和（[HR 0.31，p=0.01]）。使用LAT、HER2阳性状态和激素受体阳性状态与较长的PFS和OS有关，而肝脏转移导致PFS更差。当加入系统治疗时，LAT与OMBC的改善预后有关，并且不会明显增加毒性。确定的预后因素可以帮助医生选择接受LAT的患者。版权所有©2023作者。由Elsevier Ltd.发表。保留所有权利。

Local ablative treatment (LAT) is increasingly combined with systemic therapy in oligometastatic breast cancer (OMBC), without a high-level evidence to support this strategy. We evaluated the addition of LAT to systemic treatment in terms of progression-free survival (PFS) and overall survival (OS). Secondary endpoints were local control (LC) and toxicity. We sought to identify prognostic factors associated with longer OS and PFS.We identified consecutive patients treated between 2014 and 2018 for synchronous or metachronous OMBC (defined as ≤ 5 metastases). LAT included stereotactic body radiation therapy (SBRT) and volumetric modulated arc therapy (VMAT), surgery, cryotherapy and percutaneous radiofrequency ablation (PRA). PFS and OS were calculated, and Cox regression models analyzed for potential predictors of survival.One hundred two patients were included (no-LAT, n = 62; LAT, n = 40). Sixty-four metastases received LAT. Median follow-up was 50.4 months (95% CI [44.4; 53.4]). One patient experienced grade 3 toxicity in the LAT group. Five-year PFS and OS were 34.75% (95% CI [24.42-45.26]) and 63.21% (95% CI [50.69-73.37]) respectively. Patients receiving both LAT and systemic therapy had longer PFS and OS than those with no-LAT ([HR 0.39, p = 0.002]) and ([HR 0.31, p = 0.01]). The use of LAT, HER2-positive status and hormone-receptor positivity were associated with longer PFS and OS whereas liver metastases led to worse PFS.LAT was associated with improved outcomes in OMBC when added to systemic treatment, without significantly increasing toxicity. The prognostic factors identified to extend PFS and OS may help guide clinicians in selecting patients for LAT.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.