Literature DB >> 26183933

The role of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in the elderly.

Marta Scorsetti1, Elena Clerici1, Piera Navarria1, Giuseppe D'Agostino1, Lorenzo Piergallini1, Fiorenza De Rose1, Annamaria Ascolese1, Angelo Tozzi1, Cristina Iftode1, Elisa Villa1, Tiziana Comito1, Ciro Franzese1, Pietro Mancosu1, Stefano Tomatis1, Luca Cozzi1.   

Abstract

OBJECTIVE: To report about clinical outcome of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in elderly patients.
METHODS: Patients with 1-4 inoperable metastases were treated with SBRT. Dose prescription ranged from 40 to 75 Gy in 3-8 fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and disease-specific survival (DSS).
RESULTS: 82 patients with 111 total metastases were treated. Median age was 79 years. 64 patients (78%) had a single lesion; the remaining patients had 2-4 lesions. 16 (14.4%) lesions were localized in the abdomen, 50 (45.0%) in the liver and 45 (40.5%) in the lungs. Local response was observed for 87 lesions (78.4%) while local progression was observed in 24 lesions (21.6%). Actuarial 1-year LC was 86.8% ± 3.3%. Actuarial 1-year OS was 93.6% ± 2.7%. 2-year findings were 76.3% ± 4.4% and 72.0% ± 5.6%, respectively. Actuarial 1- and 2-year DSS results were 97.5% ± 2.0% and 81.6% ± 4.9%, respectively. Treatment-related Grade 2-3 toxicity was observed in five patients (4.2%); Grade 1 toxicity in seven patients (5.9%) and no toxicity was observed in 85.4% of the cases.
CONCLUSION: SBRT is a safe and effective therapeutic option for the treatment of oligometastatic disease in the elderly with acceptable rates of LC and low treatment-related toxicity. ADVANCES IN KNOWLEDGE: The use of SBRT for oligometastatic disease in the elderly can be considered as a valuable approach, particularly for patients with fragile status or refusing other approaches.

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Year:  2015        PMID: 26183933      PMCID: PMC4743569          DOI: 10.1259/bjr.20150111

Source DB:  PubMed          Journal:  Br J Radiol        ISSN: 0007-1285            Impact factor:   3.039


  23 in total

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2.  Is stereotactic body radiation therapy an attractive option for unresectable liver metastases? A preliminary report from a phase 2 trial.

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5.  Early-stage lung cancer in elderly patients: a population-based study of changes in treatment patterns and survival in the Netherlands.

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8.  Effectiveness of radiation therapy for elderly patients with unresected stage I and II non-small cell lung cancer.

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9.  Advanced non-small cell lung cancer in the elderly: the impact of age and comorbidities on treatment modalities and patient prognosis.

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Review 10.  Review of current best practice and priorities for research in radiation oncology for elderly patients with cancer: the International Society of Geriatric Oncology (SIOG) task force.

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1.  Radical hypo-fractionated radiotherapy with volumetric modulated arc therapy in lung cancer : A retrospective study of elderly patients with stage III disease.

Authors:  D Franceschini; F De Rose; L Cozzi; P Navarria; E Clerici; C Franzese; T Comito; A Tozzi; C Iftode; G D'Agostino; M Sorsetti
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2.  A scoring system for predicting the survival prognosis of patients receiving stereotactic body radiation therapy (SBRT) for 1-3 lung metastases.

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Journal:  Lung       Date:  2016-06-04       Impact factor: 2.584

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Review 4.  Stereotactic ablative radiotherapy for oligometastatic breast cancer in elderly patients.

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