Margriet Kwint1, Iris Walraven1, Sjaak Burgers2, Koen Hartemink3, Houke Klomp3, Joost Knegjens1, Marcel Verheij1, José Belderbos4. 1. Department of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 2. Department of Thoracic Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 3. Department of Thoracic Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. 4. Department of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: j.belderbos@nki.nl.
Abstract
OBJECTIVES: Patients with stage IV non-small cell lung cancer (NSCLC) are considered incurable and are mainly treated with palliative intent. This patient group has a poor overall survival (OS) and progression free survival (PFS). The purpose of this study was to investigate PFS and OS of NSCLC patients diagnosed with synchronous oligometastatic disease who underwent radical treatment of both intrathoracic disease and metastases. MATERIALS AND METHODS: Patients with NSCLC and oligometastatic disease at diagnosis, who were treated with radical intent between 2008 and 2016, were included in this observational study. Treatment consisted of systemic treatment and radical radiotherapy or resection of the intrathoracic disease. Treatment of the metastases consisted of radical or stereotactic radiotherapy, surgical resection or radiofrequency ablation. RESULTS AND CONCLUSIONS: Ninety-one patients (52% men, mean age 60 years) in good performance status were included. Thirty-eight patients (42%) died during follow-up (median follow-up 35 months). The cause of dead was lung cancer in all patients, except one. Sixty-three (69%) patients developed recurrent disease. Eleven recurrences (17%) occurred within the irradiated area. For the whole group, the median PFS was 14 months (range 2-89, 95%CI 12-16) and the median OS was 32 months (range 3-89, 95%CI 25-39). The 1- and 2-year OS rates were 85% and 58% and the 1- and 2-year PFS rates were 55% and 27%, respectively. Radical local treatment of a selected group of NSCLC patients with good performance status presenting with synchronous oligometastatic disease resulted in favorable long-term PFS and OS.
OBJECTIVES:Patients with stage IV non-small cell lung cancer (NSCLC) are considered incurable and are mainly treated with palliative intent. This patient group has a poor overall survival (OS) and progression free survival (PFS). The purpose of this study was to investigate PFS and OS of NSCLCpatients diagnosed with synchronous oligometastatic disease who underwent radical treatment of both intrathoracic disease and metastases. MATERIALS AND METHODS:Patients with NSCLC and oligometastatic disease at diagnosis, who were treated with radical intent between 2008 and 2016, were included in this observational study. Treatment consisted of systemic treatment and radical radiotherapy or resection of the intrathoracic disease. Treatment of the metastases consisted of radical or stereotactic radiotherapy, surgical resection or radiofrequency ablation. RESULTS AND CONCLUSIONS: Ninety-one patients (52% men, mean age 60 years) in good performance status were included. Thirty-eight patients (42%) died during follow-up (median follow-up 35 months). The cause of dead was lung cancer in all patients, except one. Sixty-three (69%) patients developed recurrent disease. Eleven recurrences (17%) occurred within the irradiated area. For the whole group, the median PFS was 14 months (range 2-89, 95%CI 12-16) and the median OS was 32 months (range 3-89, 95%CI 25-39). The 1- and 2-year OS rates were 85% and 58% and the 1- and 2-year PFS rates were 55% and 27%, respectively. Radical local treatment of a selected group of NSCLCpatients with good performance status presenting with synchronous oligometastatic disease resulted in favorable long-term PFS and OS.
Authors: Barbara Alicja Jereczek-Fossa; Barbara Bortolato; Marianna Alessandra Gerardi; Samantha Dicuonzo; Virginia Maria Arienti; Stefania Berlinghieri; Stefano Bracelli; Michela Buglione; Mariangela Caputo; Gianpiero Catalano; Luigi Franco Cazzaniga; Luigi De Cicco; Nadia Di Muzio; Francesco Romeo Filippone; Andrei Fodor; Davide Franceschini; Paolo Frata; Stefania Gottardo; Giovanni Battista Ivaldi; Antonio Laudati; Stefano Maria Magrini; Elisa Mantero; Ilaria Meaglia; Sara Morlino; Mauro Palazzi; Fabio Piccoli; Paola Romanelli; Marta Scorsetti; Flavia Serafini; Luciano Scandolaro; Riccardo Valdagni; Roberto Orecchia; Paolo Antognoni Journal: Radiol Med Date: 2018-12-15 Impact factor: 3.469
Authors: Julien P L Vincenten; Hendrik F van Essen; Birgit I Lissenberg-Witte; Nicole W J Bulkmans; Oscar Krijgsman; Daoud Sie; Paul P Eijk; Egbert F Smit; Bauke Ylstra; Erik Thunnissen Journal: PLoS One Date: 2019-10-16 Impact factor: 3.240
Authors: R de Haan; E van Werkhoven; M M van den Heuvel; H M U Peulen; G S Sonke; P Elkhuizen; M W M van den Brekel; M E T Tesselaar; C Vens; J H M Schellens; B van Triest; M Verheij Journal: BMC Cancer Date: 2019-09-10 Impact factor: 4.430