Michela Buglione1, Barbara Alicja Jereczek-Fossa2, Marco Lorenzo Bonù1, Davide Franceschini3, Andrei Fodor4, Isa Bossi Zanetti5, Marianna Alessandra Gerardi6, Paolo Borghetti7, Davide Tomasini1, Nadia Gisella Di Muzio8, Olga Oneta2, Marta Scorsetti9, Ciro Franzese3, Paola Romanelli6, Giampiero Catalano10, Italo Dell'Oca4, Giancarlo Beltramo5, Giovanni Battista Ivaldi11, Antonio Laudati12, Stefano Maria Magrini1, Paolo Antognoni13. 1. Department of Radiation Oncology, University and Spedali Civili of Brescia, Brescia, Italy. 2. Department of Radiation Oncology IEO, European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hemato-oncology University of Milan, Italy. 3. Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy. 4. Department of Radiotherapy, San Raffaele Scientific Institute, Milan, Italy. 5. Cyberknife Unit, Centro Diagnostico Italiano, Milan, Italy. 6. Department of Radiation Oncology IEO, European Institute of Oncology IRCCS, Milan, Italy. 7. Department of Radiation Oncology, University and Spedali Civili of Brescia, Brescia, Italy. Electronic address: paolobor82@yahoo.it. 8. Department of Radiotherapy, San Raffaele Scientific Institute, Milan, Italy; Department of Radiotherapy, Università Vita Salute S. Raffaele, Milan, Italy. 9. Department of Radiotherapy and Radiosurgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy. 10. Department of Radiotherapy, IRCCS MultiMedica, Sesto S. Giovanni, MI, Italy. 11. Department of Radiation Oncology ICS Maugeri, Pavia, Italy. 12. Department of Radiotherapy, ASST Lariana, Como, Italy. 13. Department of Radiotherapy, Ospedale di Circolo e Fondazione Macchi, ASST dei Sette Laghi, Varese, Italy.
Abstract
OBJECTIVES: stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) are a therapeutic option for Oligometastatic/Oligoprogressive (OM/OP) NSCLC. This retrospective multicentre analysis aims to analyse clinical outcomes and treatment related toxicity of patients treated to all sites of know disease with SRS and/or FSRT for OM/OP NSCLC in 8 Italian radiation oncology centres. MATERIALS AND METHODS: From January 2016 to January 2017 198 OM/OP NSCLC patients (pts) were treated in 8 Centres. Inclusion criteria were as follows: 1-5 lesions at onset or after previous systemic treatment; Pts must have all metastatic lesions treated. Endpoints analysed were local progression free survival (LPFS); out-of-field recurrence free survival (OFPS); progression free survival (PFS); overall survival (OS). Time to New systemic Therapy free survival (TNT) and toxicity were also analysed. RESULTS: At the time of radiotherapy, 119 pts (60 %) were treated for a single lesion, 49 (25 %) for 2 lesions, 30 (15 %) for 3-5 metastases. Total number of lesions treated was 333: 204 brain, 68 lung, 24 bone, 16 nodal, 12 adrenal, 8 liver and 1 soft tissue. 83/198 pts (41.8 %) had the primary tumour controlled at the time of the SRT. After a median follow-up of 18 months, median OS and PFS were 29.6 months and 10.6 months, respectively. One year LPFS and OPFS were 90 % and 47 %, respectively. Median TNT was 10 months. At univariate analysis factors associated with better OS were PS 0-1; controlled primary tumour, 1-2 lesions; extracranial metastasis. Multivariate analysis confirmed number of lesions <3 and extracranial metastasis to be related with better survival (Relative Risk 0.4 and 0.41, respectively). Two cases of death possibly related to brain radionecrosis were observed. CONCLUSION: OM/OP NSCLC pts treated with an ablative SRT to all metastatic sites have fair outcomes with acceptable toxicity. Better results might be achieved in case of low disease burden and extracranial possibly when primary tumour is controlled.
OBJECTIVES: stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) are a therapeutic option for Oligometastatic/Oligoprogressive (OM/OP) NSCLC. This retrospective multicentre analysis aims to analyse clinical outcomes and treatment related toxicity of patients treated to all sites of know disease with SRS and/or FSRT for OM/OP NSCLC in 8 Italian radiation oncology centres. MATERIALS AND METHODS: From January 2016 to January 2017 198 OM/OP NSCLCpatients (pts) were treated in 8 Centres. Inclusion criteria were as follows: 1-5 lesions at onset or after previous systemic treatment; Pts must have all metastatic lesions treated. Endpoints analysed were local progression free survival (LPFS); out-of-field recurrence free survival (OFPS); progression free survival (PFS); overall survival (OS). Time to New systemic Therapy free survival (TNT) and toxicity were also analysed. RESULTS: At the time of radiotherapy, 119 pts (60 %) were treated for a single lesion, 49 (25 %) for 2 lesions, 30 (15 %) for 3-5 metastases. Total number of lesions treated was 333: 204 brain, 68 lung, 24 bone, 16 nodal, 12 adrenal, 8 liver and 1 soft tissue. 83/198 pts (41.8 %) had the primary tumour controlled at the time of the SRT. After a median follow-up of 18 months, median OS and PFS were 29.6 months and 10.6 months, respectively. One year LPFS and OPFS were 90 % and 47 %, respectively. Median TNT was 10 months. At univariate analysis factors associated with better OS were PS 0-1; controlled primary tumour, 1-2 lesions; extracranial metastasis. Multivariate analysis confirmed number of lesions <3 and extracranial metastasis to be related with better survival (Relative Risk 0.4 and 0.41, respectively). Two cases of death possibly related to brain radionecrosis were observed. CONCLUSION: OM/OP NSCLCpts treated with an ablative SRT to all metastatic sites have fair outcomes with acceptable toxicity. Better results might be achieved in case of low disease burden and extracranial possibly when primary tumour is controlled.
Authors: Paola Anna Jablonska; Joaquim Bosch-Barrera; Diego Serrano; Manuel Valiente; Alfonso Calvo; Javier Aristu Journal: Cancers (Basel) Date: 2021-04-29 Impact factor: 6.639
Authors: Ben Man Fei Cheung; Kin Sang Lau; Victor Ho Fun Lee; To Wai Leung; Feng-Ming Spring Kong; Mai Yee Luk; Kwok Keung Yuen Journal: Radiat Oncol J Date: 2021-10-26
Authors: Zhengfei Zhu; Jianjiao Ni; Xuwei Cai; Shengfa Su; Hongqing Zhuang; Zhenzhou Yang; Ming Chen; Shenglin Ma; Conghua Xie; Yaping Xu; Jiancheng Li; Hong Ge; Anwen Liu; Lujun Zhao; Chuangzhou Rao; Congying Xie; Nan Bi; Zhouguang Hui; Guangying Zhu; Zhiyong Yuan; Jun Wang; Lina Zhao; Wei Zhou; Chai Hong Rim; Arturo Navarro-Martin; Ben G L Vanneste; Dirk De Ruysscher; J Isabelle Choi; Jacek Jassem; Joe Y Chang; Lucyna Kepka; Lukas Käsmann; Michael T Milano; Paul Van Houtte; Rafal Suwinski; Alberto Traverso; Hiroshi Doi; Yang-Gun Suh; Georges Noël; Natsuo Tomita; Roman O Kowalchuk; Terence T Sio; Baosheng Li; Bing Lu; Xiaolong Fu Journal: Transl Lung Cancer Res Date: 2022-09