Comparative efficacy and safety of two radiotherapy protocols for ovarian ablation in patients with metastatic breast cancer

Hossain,Tasneem; Galietta,Erika; Morganti,Alessio G.; Uddin,Abul Farah Md. Kamal; Alam,Shahida; Hossain,Altaf; Begum,Sonya; Hussain,Qazi Mushtaq; Hossain,Nowshin Taslima

doi:10.3892/mi.2025.255

September-October 2025 Volume 5 Issue 5

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September-October 2025 Volume 5 Issue 5

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Comparative efficacy and safety of two radiotherapy protocols for ovarian ablation in patients with metastatic breast cancer

Authors:
- Tasneem Hossain
- Erika Galietta
- Alessio G. Morganti
- Abul Farah Md. Kamal Uddin
- Shahida Alam
- Altaf Hossain
- Sonya Begum
- Qazi Mushtaq Hussain
- Nowshin Taslima Hossain
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Affiliations: Department of Radiation Oncology, National Institute of Cancer Research and Hospital, Dhaka 1212, Bangladesh, Radiation Oncology, IRCCS Azienda Ospedaliero‑Universitaria di Bologna, I-40138 Bologna, Italy, Department of Radiation Oncology, National Institute of ENT, Dhaka 1212, Bangladesh, Department of Radiation Oncology, Khulna Medical College and Hospital, Khulna 9208, Bangladesh, Department of Oncology, Delta Hospital Limited, Dhaka 1216, Bangladesh, Clinical and Radiation Oncology, Labaid Cancer and Superspeciality Centre, Dhaka 1205, Bangladesh, Department of Radiation Oncology, Ahsania Mission Cancer and General Hospital, Dhaka 1230, Bangladesh

Copyright: © Hossain et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
Article Number: 56
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Published online on: July 23, 2025

https://doi.org/10.3892/mi.2025.255
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Abstract

The present study aimed to evaluate the efficacy and safety of radiotherapy (RT) for ovarian ablation (OA) in patients with metastatic breast cancer by comparing two RT protocols: 15 Gy in 5 fractions (arm A) vs. 20 Gy in 10 fractions (arm B). For this purpose, the present study enrolled 68 patients, divided equally into two study arms. The patients were followed‑up for 24 weeks post‑intervention. The primary endpoint was the efficacy of RT in inducing OA, assessed through amenorrhea and hormone levels [follicle‑stimulating hormone (FSH) and estradiol]. Toxicities were evaluated using the Common Toxicity Criteria for Adverse Events version 5.0, and post‑menopausal symptoms were assessed using the Menopause Rating Scale. The results revealed that there was no significant difference between the two study arms (A vs. B) in the rate of amenorrhea development and persistence (85.7 vs. 89.5%), and in the achievement of postmenopausal estradiol (91.2 vs. 94.1%) and FSH levels (79.4 vs. 88.2%). Both regimens led to a significant reduction in estradiol levels and an increase in FSH levels compared to baseline levels. No grade ≥3 toxicity was observed. Common postmenopausal symptoms included hot flushes and irritability, with no significant differences between the groups. On the whole, the present study demonstrates that both RT regimens are effective and safe for OA in patients with metastatic breast cancer, with no significant differences in efficacy or toxicity. The findings are particularly relevant in resource‑limited settings, underscoring the potential for flexible and shorter treatment regimens in such environment.

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1	Arnold M, Morgan E, Rumgay H, Mafra A, Singh D, Laversanne M, Vignat J, Gralow JR, Cardoso F, Siesling S and Soerjomataram I: Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast. 66:15–23. 2022.PubMed/NCBI View Article : Google Scholar
2	Ferlay J, Ervik M, Lam F, Laversanne M, Colombet M, Mery L, Piñeros M, Znaor A, Soerjomataram I and Bray F: Global Cancer Observatory: Cancer Today. International Agency for Research on Cancer, Lyon, 2024. Available from: https://gco.iarc.who.int/today. Accessed March 2, 2024.
3	Celio L, Bajetta E, Toffolatti L, Catena L, Beretta E and Buzzoni R: Ovarian ablation for premenopausal early-stage breast cancer: An update. Tumori. 86:191–194. 2000.PubMed/NCBI View Article : Google Scholar
4	Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0. Published November 27, 2017. Available from: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_5x7.pdf.
5	Asiri MA, Tunio MA and Abdulmoniem R: Is radiation-induced ovarian ablation in breast cancer an obsolete procedure? Results of a meta-analysis. Breast Cancer (Dove Med Press). 8:109–116. 2016.PubMed/NCBI View Article : Google Scholar
6	Bese NS, Iribas A, Dirican A, Oksuz D, Atkovar G and Ober A: Ovarian ablation by radiation therapy: Is it still an option for the ablation of ovarian function in endocrine responsive premenopausal breast cancer patients? Breast. 18:304–308. 2009.PubMed/NCBI View Article : Google Scholar
7	Hughes LL, Gray RJ, Solin LJ, Robert NJ, Martino S, Tripathy D, Ingle JN and Wood WC: Eastern Cooperative Oncology Group; Southwest Oncology Group et al. Efficacy of radiotherapy for ovarian ablation: Results of a breast intergroup study. Cancer. 101:969–972. 2004.PubMed/NCBI View Article : Google Scholar
8	Boccardo F, Rubagotti A, Perrotta A, Amoroso D, Balestrero M, De Matteis A, Zola P, Sismondi P, Francini G, Petrioli R, et al: Ovarian ablation versus goserelin with or without tamoxifen in pre-perimenopausal patients with advanced breast cancer: Results of a multicentric Italian study. Ann Oncol. 5:337–342. 1994.PubMed/NCBI View Article : Google Scholar
9	Ejlertsen B, Mouridsen HT, Jensen MB, Bengtsson NO, Bergh J, Cold S, Edlund P, Ewertz M, de Graaf PW, Kamby C and Nielsen DL: Similar efficacy for ovarian ablation compared with cyclophosphamide, methotrexate, and fluorouracil: From a randomized comparison of premenopausal patients with node-positive, hormone receptor-positive breast cancer. J Clin Oncol. 24:4956–4962. 2006.PubMed/NCBI View Article : Google Scholar
10	Thürlimann B, Price KN, Gelber RD, Holmberg SB, Crivellari D, Colleoni M, Collins J, Forbes JF, Castiglione-Gertsch M, Coates AS, et al: Is chemotherapy necessary for premenopausal women with lower-risk node-positive, endocrine responsive breast cancer? 10-year update of international breast cancer study group trial 11-93. Breast Cancer Res Treat. 113:137–144. 2009.PubMed/NCBI View Article : Google Scholar
11	Thomson CS, Twelves CJ, Mallon EA and Leake RE: Scottish Cancer Trials Breast Group and Scottish Cancer Therapy Network. Adjuvant ovarian ablation vs cmF chemotherapy in premenopausal breast cancer patients: Trial update and impact of immunohistochemical assessment of ER status. Breast. 11:419–429. 2002.PubMed/NCBI View Article : Google Scholar
12	Adjuvant Breast Cancer Trials Collaborative Group. Ovarian ablation or suppression in premenopausal early breast cancer: Results from the international adjuvant breast cancer ovarian ablation or suppression randomized trial. J Natl Cancer Inst. 99:516–525. 2007.PubMed/NCBI View Article : Google Scholar

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Comparative efficacy and safety of two radiotherapy protocols for ovarian ablation in patients with metastatic breast cancer

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