Primary XXXX with Synchronous Metastatic Disease - Indications for Local Radiotherapy to the Breast and Chest Wall.

@entity1 @entity0
AIM: To review literature on local therapy in @entity1 with primary metastatic @entity0 with focus on local radiotherapy (RT). @entity1 AND METHODS: A Medline search using the key words "metastatic @entity0 ", "primary resection/radiotherapy", "local therapy", "local radiotherapy" was carried out. All original studies in the English language were included in the present review. RESULTS: A total of 27 original studies including more than 33,000 @entity1 with metastatic @entity0 were identified, including two large database analyses (n=25,757). All studies were retrospective in nature. Most studies showed a survival benefit with the addition of local therapy in a metastatic situation. The majority of studies focused on the role of surgery. Fourteen studies (52%) mentioned radiotherapy (RT) in 0.3% to 100% of @entity1 . Six of these studies analyzed the effect of RT separately and five found an additional benefit of RT. Two studies showed best outcomes when RT and surgery were combined. CONCLUSION: Most retrospective studies showed a survival benefit for local therapy in @entity1 with @entity0 with distant metastases. The role of RT remains unclear. Some reports showed improved outcome with the combination of surgery and RT. This approach should be considered in @entity1 with good survival prognosis in whom local control is important. There are several prognostic factors to aid decision-making. Results of prospective randomized studies are pending.
