Would you treat with consolidative SBRT for oligometastatic liver mets from HER2+ breast cancer if these lesions demonstrated radiographic CR/near-CR following neoadjuvant TCHP chemotherapy (and patient is receiving ongoing adjuvant HP therapy)?

Due to respiratory motion and resolution of the lesions on re-staging imaging, targeting the lesions on CT sim is extremely difficult. Also, is consolidative SBRT even indicated in the setting of CR/near CR of these lesions with HER2 directed therapy and patient's receipt of ongoing adjuvant HP therapy?

Answer from: Radiation Oncologist at Community Practice

I would not if radiographic CR or near CR. If there any suspicions of residual disease vs. scar, favor surgery, which will establish diagnosis and also take care of oligomets.

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Would you treat with consolidative SBRT for oligometastatic liver mets from HER2+ breast cancer if these lesions demonstrated radiographic CR/near-CR following neoadjuvant TCHP chemotherapy (and patient is receiving ongoing adjuvant HP therapy)?

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