{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T12:51:14Z","timestamp":1777899074905,"version":"3.51.4"},"reference-count":56,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The optimal management of bone-only progressive disease (PD) in metastatic breast cancer remains unclear for several reasons. Radiologic diagnosis of bone PD is complicated by the lack of standardized response assessment criteria, unspecific morphologic changes of the bone, and flare-up phenomena. Furthermore, bone-only disease and oligoprogression have been associated with favorable prognosis challenging a change of systemic treatment with the consequence of limited treatment options in the future. Additionally, bone-only metastatic disease is frequently excluded from clinical trials resulting in scarce data. This study aimed to assess the therapeutic management and outcome of bone-only PD in metastatic breast cancer patients in a real-world academic setting. Methods: A retrospective analysis of all breast cancer patients with bone metastases (BMs) and at least one event of radiologic evidence of bone-only PD and\/or the occurrence of a skeletal-related event (SRE) who were treated at the Department of Obstetrics and Gynecology of the Medical University of Vienna, Austria, between 1 January 2015 and 14 December 2021 was performed. In cases of multiple bone-only PD events in one patient only the first event was considered for analysis. All cases with PD in organs other than the bone were excluded. The primary outcome of the study was to assess therapeutic measures of bone-only PD. Secondary outcomes were the time from bone-only PD to next bone PD (TTF BD) and overall survival (OS; time from bone-only PD to death). Predictors of TTF BD and OS were assessed as exploratory outcomes. Results: Out of a total of 308 breast cancer patients with BMs, 57 had at least one event of bone-only PD. In 59.3% of bone-only PD cases the systemic treatment was continued with a numerically higher rate if multiple metastatic sites were present (71.4% vs. 46.4%). In most bone-only PD events the bone-targeted agent (BTA) was continued (94.5%), independent of the total number of metastatic sites. In 24.1% radiotherapy (RT) was administered with similar rates between patients with bone-only and multiple metastatic sites. The median TTF BD was 6.3 months. In multivariate analysis no predictor for TTF BD could be identified including change of systemic treatment, RT, previous BTA treatment duration, number of previous treatment lines for the metastatic disease, number of metastatic sites and previous or current SRE. Median OS was 21.8 months. Number of previous treatment lines for the metastatic setting was significantly associated with OS with shorter OS in the more advanced disease stage (p-value = 0.0208). Conclusions: Systemic and BTA treatment were continued in the majority of bone-only PD cases. In 24.1% RT was administered. No association between change of systemic therapy and improved oncologic outcome was found. The study\u2019s results are hypothesis-generating in terms of whether change of systemic treatment should be performed restrictively to avoid limited treatment options in the future. Similarly, radiotherapy did not ameliorate prognosis.<\/jats:p>","DOI":"10.3390\/jcm15093456","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:33:17Z","timestamp":1777627997000},"page":"3456","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Bone-Only Progressive Disease in Metastatic Breast Cancer\u2014A Retrospective Single-Center Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Christine","family":"Deutschmann","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Clauser","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0523-5696","authenticated-orcid":false,"given":"Florian","family":"Heinzl","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daphne","family":"Gschwantler-Kaulich","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1294-0027","authenticated-orcid":false,"given":"Christian F.","family":"Singer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5230-4853","authenticated-orcid":false,"given":"Carmen","family":"Leser","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4316-6399","authenticated-orcid":false,"given":"Sabine","family":"Danzinger","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Patrzek","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Anzengruber","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Krepper","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg","family":"Pfeiler","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1002\/(SICI)1097-0142(19971015)80:8+<1588::AID-CNCR9>3.0.CO;2-G","article-title":"Skeletal complications of malignancy","volume":"80","author":"Coleman","year":"1997","journal-title":"Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1038\/nrc867","article-title":"Metastasis to bone: Causes, consequences and therapeutic opportunities","volume":"2","author":"Mundy","year":"2002","journal-title":"Nat. Rev. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"6243s","DOI":"10.1158\/1078-0432.CCR-06-0931","article-title":"Clinical features of metastatic bone disease and risk of skeletal morbidity","volume":"12","author":"Coleman","year":"2006","journal-title":"Clin. Cancer Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s10549-011-1475-5","article-title":"Survival in breast cancer patients with bone metastases and skeletal-related events: A population-based cohort study in Denmark (1999\u20132007)","volume":"129","author":"Yong","year":"2011","journal-title":"Breast Cancer Res. Treat."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1053\/j.seminoncol.2010.10.002","article-title":"Implications of bone metastases and the benefits of bone-targeted therapy","volume":"37","author":"Lipton","year":"2010","journal-title":"Semin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1002\/jso.22061","article-title":"Survival analysis of patients with femoral metastases","volume":"105","author":"Mavrogenis","year":"2012","journal-title":"J. Surg. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1002\/cncr.22991","article-title":"Pathologic fractures correlate with reduced survival in patients with malignant bone disease","volume":"110","author":"Saad","year":"2007","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1016\/j.annonc.2020.07.019","article-title":"Bone health in cancer: ESMO Clinical Practice Guidelines","volume":"31","author":"Coleman","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_9","first-page":"2981","article-title":"Antineoplastic activity of zoledronic acid and denosumab","volume":"33","author":"Zwolak","year":"2013","journal-title":"Anticancer Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1038\/sj.bjc.6600925","article-title":"New insights into the actions of bisphosphonate zoledronic acid in breast cancer cells by dual RhoA-dependent and -independent effects","volume":"88","author":"Denoyelle","year":"2003","journal-title":"Br. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1359\/JBMR.040305","article-title":"A single-dose placebo-controlled study of AMG 162, a fully human monoclonal antibody to RANKL, in postmenopausal women","volume":"19","author":"Bekker","year":"2004","journal-title":"J. Bone Miner. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/j.bone.2010.11.020","article-title":"Denosumab and bisphosphonates: Different mechanisms of action and effects","volume":"48","author":"Baron","year":"2011","journal-title":"Bone"},{"key":"ref_13","first-page":"43","article-title":"Skeletal scintigraphy in breast cancer management","volume":"42","author":"Bares","year":"1998","journal-title":"Q. J. Nucl. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1016\/S8756-3282(09)80011-2","article-title":"Metastatic bone disease: Clinical and therapeutic aspects","volume":"13","author":"Body","year":"1992","journal-title":"Bone"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.critrevonc.2013.05.015","article-title":"Bone effects of mammalian target of rapamycin (mTOR) inhibition with everolimus","volume":"87","author":"Hadji","year":"2013","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1200\/JCO.2017.74.6917","article-title":"US Food and Drug Administration Pooled Analysis to Assess the Impact of Bone-Only Metastatic Breast Cancer on Clinical Trial Outcomes and Radiographic Assessments","volume":"36","author":"Wedam","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1016\/j.clon.2019.05.015","article-title":"The Dandelion Dilemma Revisited for Oligoprogression: Treat the Whole Lawn or Weed Selectively?","volume":"31","author":"Patel","year":"2019","journal-title":"Clin. Oncol. (R. Coll. Radiol.)"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Wang, R., Zhu, Y., Liu, X., Liao, X., He, J., and Niu, L. (2019). The Clinicopathological features and survival outcomes of patients with different metastatic sites in stage IV breast cancer. BMC Cancer, 19.","DOI":"10.1186\/s12885-019-6311-z"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1758835920987657","DOI":"10.1177\/1758835920987657","article-title":"Real-life prognosis of 5041 bone-only metastatic breast cancer patients in the multicenter national observational ESME program","volume":"13","author":"Bertho","year":"2021","journal-title":"Ther. Adv. Med. Oncol."},{"key":"ref_20","first-page":"1029","article-title":"Denosumab versus bisphosphonates in patients with advanced cancers-related bone metastasis: Systematic review and meta-analysis of randomized controlled trials","volume":"26","author":"Menshawy","year":"2018","journal-title":"Support. Care Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ejca.2008.10.026","article-title":"New response evaluation criteria in solid tumours: Revised RECIST guideline (version 1.1)","volume":"45","author":"Eisenhauer","year":"2009","journal-title":"Eur. J. Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Fournier, L., de Geus-Oei, L.F., Regge, D., Oprea-Lager, D.E., D\u2019Anastasi, M., Bidaut, L., Bauerle, T., Lopci, E., Cappello, G., and Lecouvet, F. (2021). Twenty Years On: RECIST as a Biomarker of Response in Solid Tumours an EORTC Imaging Group\u2014ESOI Joint Paper. Front. Oncol., 11.","DOI":"10.3389\/fonc.2021.800547"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.ctrv.2010.04.003","article-title":"Metastasis and bone loss: Advancing treatment and prevention","volume":"36","author":"Coleman","year":"2010","journal-title":"Cancer Treat. Rev."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Savas, P., Teo, Z.L., Lefevre, C., Flensburg, C., Caramia, F., Alsop, K., Mansour, M., Francis, P.A., Thorne, H.A., and Silva, M.J. (2016). The Subclonal Architecture of Metastatic Breast Cancer: Results from a Prospective Community-Based Rapid Autopsy Program \u201cCASCADE\u201d. PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1002204"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1093\/annonc\/mdr397","article-title":"Imaging bone metastases in breast cancer: Evidence on comparative test accuracy","volume":"23","author":"Houssami","year":"2012","journal-title":"Ann. Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.jacr.2010.02.015","article-title":"ACR appropriateness criteria on metastatic bone disease","volume":"7","author":"Roberts","year":"2010","journal-title":"J. Am. Coll. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/BF02993710","article-title":"Recent advances in 99mTc radiopharmaceuticals","volume":"16","author":"Arano","year":"2002","journal-title":"Ann. Nucl. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1001\/jama.1975.03260250020018","article-title":"Limitations of bone scanning in clinical oncology","volume":"234","author":"Loeffler","year":"1975","journal-title":"JAMA"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1200\/JCO.2015.64.2702","article-title":"Trial Design and Objectives for Castration-Resistant Prostate Cancer: Updated Recommendations From the Prostate Cancer Clinical Trials Working Group 3","volume":"34","author":"Scher","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1053\/ctrv.2000.0210","article-title":"Metastatic bone disease: Clinical features, pathophysiology and treatment strategies","volume":"27","author":"Coleman","year":"2001","journal-title":"Cancer Treat. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"849","DOI":"10.3109\/07357907.2010.483508","article-title":"Disease progression increases the risk of skeletal-related events in patients with bone metastases from castration-resistant prostate cancer, lung cancer, or other solid tumors","volume":"28","author":"Tchekmedyian","year":"2010","journal-title":"Cancer Investig."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"170","DOI":"10.3816\/CLC.2004.n.030","article-title":"Clinical benefit of zoledronic acid in patients with lung cancer and other solid tumors: Analysis based on history of skeletal complications","volume":"6","author":"Hirsh","year":"2004","journal-title":"Clin. Lung Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"3082","DOI":"10.1016\/j.ejca.2012.08.002","article-title":"Superiority of denosumab to zoledronic acid for prevention of skeletal-related events: A combined analysis of 3 pivotal, randomised, phase 3 trials","volume":"48","author":"Lipton","year":"2012","journal-title":"Eur. J. Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4841","DOI":"10.1158\/1078-0432.CCR-11-3310","article-title":"Bone-related complications and quality of life in advanced breast cancer: Results from a randomized phase III trial of denosumab versus zoledronic acid","volume":"18","author":"Martin","year":"2012","journal-title":"Clin. Cancer Res."},{"key":"ref_35","first-page":"447","article-title":"Safety of long-term denosumab therapy: Results from the open label extension phase of two phase 3 studies in patients with metastatic breast and prostate cancer","volume":"24","author":"Stopeck","year":"2016","journal-title":"Support. Care Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1634\/theoncologist.2014-0328","article-title":"Systematic literature review and network meta-analysis comparing bone-targeted agents for the prevention of skeletal-related events in cancer patients with bone metastasis","volume":"20","author":"Wang","year":"2015","journal-title":"Oncologist"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1080\/13696998.2019.1651122","article-title":"Cost-effectiveness of denosumab for the prevention of skeletal-related events in patients with solid tumors and bone metastases in the United States","volume":"23","author":"Stopeck","year":"2020","journal-title":"J. Med. Econ."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1002\/jbmr.71","article-title":"Preventing metastases to bone: Denosumab or bisphosphonates?","volume":"25","author":"Nanes","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"6690","DOI":"10.1158\/1078-0432.CCR-07-5234","article-title":"Extended efficacy and safety of denosumab in breast cancer patients with bone metastases not receiving prior bisphosphonate therapy","volume":"14","author":"Lipton","year":"2008","journal-title":"Clin. Cancer Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.ctrv.2008.05.001","article-title":"Bone markers and their prognostic value in metastatic bone disease: Clinical evidence and future directions","volume":"34","author":"Coleman","year":"2008","journal-title":"Cancer Treat. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1016\/j.clinthera.2020.05.019","article-title":"Denosumab Versus Zoledronic Acid in the Prevention of Skeletal-related Events in Vulnerable Cancer Patients: A Meta-analysis of Randomized, Controlled Trials","volume":"42","author":"Chen","year":"2020","journal-title":"Clin. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Zheng, G.Z., Chang, B., Lin, F.X., Xie, D., Hu, Q.X., Yu, G.Y., Du, S.X., and Li, X.D. (2017). Meta-analysis comparing denosumab and zoledronic acid for treatment of bone metastases in patients with advanced solid tumours. Eur. J. Cancer Care, 26.","DOI":"10.1111\/ecc.12541"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1359\/jbmr.090810","article-title":"Effects of denosumab in patients with bone metastases with and without previous bisphosphonate exposure","volume":"25","author":"Body","year":"2010","journal-title":"J. Bone Miner. Res."},{"key":"ref_44","first-page":"e20.00045","article-title":"Bisphosphonates Versus Denosumab for Prevention of Pathological Fracture in Advanced Cancers with Bone Metastasis: A Meta-analysis of Randomized Controlled Trials","volume":"4","author":"Frazer","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg. Glob. Res. Rev."},{"key":"ref_45","first-page":"679","article-title":"Delaying skeletal-related events in a randomized phase 3 study of denosumab versus zoledronic acid in patients with advanced cancer: An analysis of data from patients with solid tumors","volume":"22","author":"Henry","year":"2014","journal-title":"Support. Care Cancer"},{"key":"ref_46","first-page":"CD003474","article-title":"Bisphosphonates and other bone agents for breast cancer","volume":"10","author":"Wong","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ejca.2015.09.011","article-title":"Effect of denosumab versus zoledronic acid in preventing skeletal-related events in patients with bone metastases by baseline characteristics","volume":"53","author":"Lipton","year":"2016","journal-title":"Eur. J. Cancer"},{"key":"ref_48","first-page":"5223","article-title":"Real-world use of denosumab and bisphosphonates in patients with solid tumours and bone metastases in Germany","volume":"28","author":"Diel","year":"2020","journal-title":"Support. Care Cancer"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1007\/s11912-024-01529-2","article-title":"Navigating Breast Cancer Oligometastasis and Oligoprogression: Current Landscape and Future Directions","volume":"26","author":"Yoon","year":"2024","journal-title":"Curr. Oncol. Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1200\/JCO.2008.19.2146","article-title":"Randomized phase II trial of denosumab in patients with bone metastases from prostate cancer, breast cancer, or other neoplasms after intravenous bisphosphonates","volume":"27","author":"Fizazi","year":"2009","journal-title":"J. Clin. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1002\/cncr.23529","article-title":"Normalization of bone markers is associated with improved survival in patients with bone metastases from solid tumors and elevated bone resorption receiving zoledronic acid","volume":"113","author":"Lipton","year":"2008","journal-title":"Cancer"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0140-6736(23)01857-3","article-title":"Standard-of-care systemic therapy with or without stereotactic body radiotherapy in patients with oligoprogressive breast cancer or non-small-cell lung cancer (Consolidative Use of Radiotherapy to Block [CURB] oligoprogression): An open-label, randomised, controlled, phase 2 study","volume":"403","author":"Tsai","year":"2024","journal-title":"Lancet"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.1016\/j.ijrobp.2023.08.033","article-title":"Stereotactic ablative body radiotherapy (SABR) for oligoprogressive ER-positive breast cancer (AVATAR): A phase II prospective multicenter trial","volume":"117","author":"David","year":"2023","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1634\/theoncologist.2018-0085","article-title":"Prognostic Factors in Patients with Metastatic Breast Cancer with Bone-Only Metastases","volume":"23","author":"Parkes","year":"2018","journal-title":"Oncologist"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/1097-0142(20010101)91:1<17::AID-CNCR3>3.0.CO;2-K","article-title":"Prognostic significance of the number of bone scan abnormalities at the time of initial bone metastatic recurrence in breast carcinoma","volume":"91","author":"Jacobson","year":"2001","journal-title":"Cancer"},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Koizumi, M., Yoshimoto, M., Kasumi, F., Iwase, T., and Ogata, E. (2010). Post-operative breast cancer patients diagnosed with skeletal metastasis without bone pain had fewer skeletal-related events and deaths than those with bone pain. BMC Cancer, 10.","DOI":"10.1186\/1471-2407-10-423"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/9\/3456\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:49:51Z","timestamp":1777628991000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/9\/3456"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":56,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["jcm15093456"],"URL":"https:\/\/doi.org\/10.3390\/jcm15093456","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]}}}