R J Klement1, J Hoerner-Rieber2, S Adebahr3, N Andratschke4, O Blanck5, J Boda-Heggemann6, M Duma7, M J Eble8, H C Eich9, M Flentje10, S Gerum11, P Hass12, C Henkenberens13, G Hildebrandt14, D Imhoff15, K H Kahl16, N D Klass17, R Krempien18, F Lohaus19, C Petersen20, E Schrade21, T G Wendt22, A Wittig23, M Guckenberger24. 1. Department of Radiation Oncology, Leopoldina Hospital, Schweinfurt, Germany. 2. Department of Radiation Oncology, University Hospital Heidelberg, Germany; National Center for Radiation Oncology (NCRO), Heidelberg Institute for Radiation Oncology (HIRO), Heidelberg, Germany. 3. Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Germany. 4. Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland. 5. Department of Radiation Oncology, UKSH Universitätsklinikum Schleswig Holstein, Kiel, Germany. 6. Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Germany. 7. Department of Radiation Oncology, Technical University Munich, Germany. 8. Department of Radiation Oncology, University Hospital Aachen, Germany. 9. Department of Radiation Oncology, University Hospital Münster, Germany. 10. Department of Radiation Oncology, University Hospital Wuerzburg, Germany. 11. Department of Radiation Oncology, Ludwig Maximilians University Munich, Germany. 12. Department of Radiation Oncology, University Hospital Magdeburg, Germany. 13. Department of Radiotherapy and Special Oncology, Medical School Hannover, Germany. 14. Department of Radiation Oncology, University of Rostock, Germany. 15. Department of Radiation Oncology, University Hospital Frankfurt, Germany. 16. Department of Radiation Oncology, Hospital Augsburg, Germany. 17. Department of Radiation Oncology, Bern University Hospital, Switzerland. 18. Department of Radiation Oncology, Helios Klinikum Berlin Buch, Germany. 19. German Cancer Research Center (DKFZ), Heidelberg, Germany; German Cancer Consortium (DKTK), Germany; Department of Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; OncoRay - National Center for Radiation Research in Oncology (NCRO), Germany. 20. Department of Radiation Oncology, University Hospital Hamburg, Germany. 21. Department of Radiation Oncology, Hospital Heidenheim, Germany. 22. Department of Radiation Oncology, University Hospital Jena, Germany. 23. Department of Radiotherapy and Radiation Oncology, Philipps-University Marburg, University Hospital Giessen and Marburg, Germany. 24. Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Switzerland. Electronic address: Matthias.Guckenberger@usz.ch.
Abstract
BACKGROUND: Stereotactic body radiotherapy (SBRT) for oligometastatic disease is characterized by an excellent safety profile; however, experiences are mostly based on treatment of one single metastasis. It was the aim of this study to evaluate safety and efficacy of SBRT for multiple pulmonary metastases. PATIENTS AND METHODS: This study is based on a retrospective database of the DEGRO stereotactic working group, consisting of 637 patients with 858 treatments. Cox regression and logistic regression were used to analyze the association between the number of SBRT treatments or the number and the timing of repeat SBRT courses with overall survival (OS) and the risk of early death. RESULTS: Out of 637 patients, 145 patients were treated for multiple pulmonary metastases; 88 patients received all SBRT treatments within one month whereas 57 patients were treated with repeat SBRT separated by at least one month. Median OS for the total patient population was 23.5 months and OS was not significantly influenced by the overall number of SBRT treatments or the number and timing of repeat SBRT courses. The risk of early death within 3 and 6 months was not increased in patients treated with multiple SBRT treatments, and no grade 4 or grade 5 toxicity was observed in these patients. CONCLUSIONS: In appropriately selected patients, synchronous SBRT for multiple pulmonary oligometastases and repeat SBRT may have a comparable safety and efficacy profile compared to SBRT for one single oligometastasis.
BACKGROUND: Stereotactic body radiotherapy (SBRT) for oligometastatic disease is characterized by an excellent safety profile; however, experiences are mostly based on treatment of one single metastasis. It was the aim of this study to evaluate safety and efficacy of SBRT for multiple pulmonary metastases. PATIENTS AND METHODS: This study is based on a retrospective database of the DEGRO stereotactic working group, consisting of 637 patients with 858 treatments. Cox regression and logistic regression were used to analyze the association between the number of SBRT treatments or the number and the timing of repeat SBRT courses with overall survival (OS) and the risk of early death. RESULTS: Out of 637 patients, 145 patients were treated for multiple pulmonary metastases; 88 patients received all SBRT treatments within one month whereas 57 patients were treated with repeat SBRT separated by at least one month. Median OS for the total patient population was 23.5 months and OS was not significantly influenced by the overall number of SBRT treatments or the number and timing of repeat SBRT courses. The risk of early death within 3 and 6 months was not increased in patients treated with multiple SBRT treatments, and no grade 4 or grade 5 toxicity was observed in these patients. CONCLUSIONS: In appropriately selected patients, synchronous SBRT for multiple pulmonary oligometastases and repeat SBRT may have a comparable safety and efficacy profile compared to SBRT for one single oligometastasis.
Authors: Claudio Fiorino; Matthias Guckemberger; Marco Schwarz; Uulke A van der Heide; Ben Heijmen Journal: Mol Oncol Date: 2020-03-19 Impact factor: 6.603
Authors: Caroline John; Riccardo Dal Bello; Nicolaus Andratschke; Matthias Guckenberger; Judit Boda-Heggemann; Eleni Gkika; Frederick Mantel; Hanno M Specht; Carmen Stromberger; Franz Zehentmayr; Oliver Blanck; Panagiotis Balermpas Journal: Sci Rep Date: 2021-02-25 Impact factor: 4.379