Luca Nicosia1, Francesco Cuccia2, Rosario Mazzola2, Vanessa Figlia2, Niccolò Giaj-Levra2, Francesco Ricchetti2, Michele Rigo2, Marco Bonù3, Stefanie Corradini4, Maria Tolia5, Filippo Alongi2,6. 1. Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, via Don Sempreboni 5, 37034, Verona, Negrar, Italy. lucanicosia.rg@gmail.com. 2. Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, via Don Sempreboni 5, 37034, Verona, Negrar, Italy. 3. Radiation Oncology Department, ASST Spedali Civili di Brescia, Brescia University, Brescia, Italy. 4. Radiation Oncology Department, University Hospital, LMU Munich, Munich, Germany. 5. Department of Radiotherapy/Radiation Oncology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larisa, Biopolis, 41500, Larisa, Greece. 6. University of Brescia, Brescia, Italy.
Abstract
PURPOSE: SBRT demonstrated to increase survival in oligometastatic patients. Nevertheless, little is known regarding the natural history of oligometastatic disease (OMD) and how SBRT may impact the transition to the polymetastatic disease (PMD). METHODS: 97 liver metastases in 61 oligometastatic patients were treated with SBRT. Twenty patients (33%) had synchronous oligometastases, 41 (67%) presented with metachronous oligometastases. Median number of treated metastases was 2 (range 1-5). RESULTS: Median follow-up was 24 months. Median tPMC was 11 months (range 4-17 months). Median overall survival (OS) was 23 months (range 16-29 months). Cancer-specific survival predictive factors were having further OMD after SBRT (21 months versus 15 months; p = 0.00), and local control of treated metastases (27 months versus 18 months; p = 0.031). Median PFS was 7 months (range 4-12 months). Patients with 1 metastasis had longer median PFS as compared to those with 2-3 and 4-5 metastases (14.7 months versus 5.3 months versus 6.5 months; p = 0.041). At the last follow-up, 50/61 patients (82%) progressed, 16 of which (26.6%) again as oligometastatic and 34 (56%) as polymetastatic. CONCLUSION: In the setting of oligometastatic disease, SBRT is able to delay the transition to the PMD. A proportion of patients relapse as oligometastatic and can be eventually evaluated for a further SBRT course. Interestingly, those patients retain a survival benefit as compared to those who had PMD. Further studies are needed to explore the role of SBRT in OMD and to identify treatment strategies able to maintain the oligometastatic state.
PURPOSE: SBRT demonstrated to increase survival in oligometastatic patients. Nevertheless, little is known regarding the natural history of oligometastatic disease (OMD) and how SBRT may impact the transition to the polymetastatic disease (PMD). METHODS: 97 liver metastases in 61 oligometastatic patients were treated with SBRT. Twenty patients (33%) had synchronous oligometastases, 41 (67%) presented with metachronous oligometastases. Median number of treated metastases was 2 (range 1-5). RESULTS: Median follow-up was 24 months. Median tPMC was 11 months (range 4-17 months). Median overall survival (OS) was 23 months (range 16-29 months). Cancer-specific survival predictive factors were having further OMD after SBRT (21 months versus 15 months; p = 0.00), and local control of treated metastases (27 months versus 18 months; p = 0.031). Median PFS was 7 months (range 4-12 months). Patients with 1 metastasis had longer median PFS as compared to those with 2-3 and 4-5 metastases (14.7 months versus 5.3 months versus 6.5 months; p = 0.041). At the last follow-up, 50/61 patients (82%) progressed, 16 of which (26.6%) again as oligometastatic and 34 (56%) as polymetastatic. CONCLUSION: In the setting of oligometastatic disease, SBRT is able to delay the transition to the PMD. A proportion of patients relapse as oligometastatic and can be eventually evaluated for a further SBRT course. Interestingly, those patients retain a survival benefit as compared to those who had PMD. Further studies are needed to explore the role of SBRT in OMD and to identify treatment strategies able to maintain the oligometastatic state.
Entities:
Keywords:
Liver metastases; Oligometastatic disease; SBRT; Stereotactic body radiotherapy
Authors: Peter Wust; Marcus Beck; Robert Dabrowski; Oliver Neumann; Sebastian Zschaeck; David Kaul; Dominik P Modest; Carmen Stromberger; Bernhard Gebauer; Pirus Ghadjar Journal: Radiat Oncol Date: 2021-03-16 Impact factor: 3.481
Authors: Xuguang Chen; Hanbo Chen; Ian Poon; Darby Erler; Serena Badellino; Tithi Biswas; Roi Dagan; Matthew Foote; Alexander V Louie; Umberto Ricardi; Arjun Sahgal; Kristin J Redmond Journal: Cancer Med Date: 2021-08-25 Impact factor: 4.452