Overall and chemotherapy-free survival following stereotactic body radiation therapy for abdominopelvic oligometastases.
SABR
SBRT
abdomen
oligometastases
pelvis
stereotactic
Journal
Journal of medical imaging and radiation oncology
ISSN: 1754-9485
Titre abrégé: J Med Imaging Radiat Oncol
Pays: Australia
ID NLM: 101469340
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
27
01
2020
accepted:
10
05
2020
pubmed:
5
6
2020
medline:
3
7
2021
entrez:
5
6
2020
Statut:
ppublish
Résumé
Limited data establish the efficacy and safety of SBRT in the abdominopelvic (AP) space, where SBRT delivery is challenging due to the proximity of radiosensitive luminal gastrointestinal (GI) organs. The aim of this study was to assess clinical outcomes in patients with AP OM treated with SBRT. Eligible patients were those with OM (defined as metastases in ≤3 total sites) in the AP space (excluding liver) treated with SBRT. Descriptive statistics and Kaplan-Meier estimates of (LC), progression-free survival (PFS), overall survival (OS) and chemotherapy-free survival (CFS) were performed. Fifty-one patients with 58 AP OM received SBRT between 2011 and 2015. Median follow-up was 21.9 months. All SBRT treatments were delivered in 5 fractions with a median dose of 35 Gy (25-40 Gy). Progression post-SBRT occurred in 38/51 patients (75%), with a median PFS of 4.9 months (95% CI: 2.5-7.5), and 2-year PFS of 29%. Rates of 2-and 4-year LC were 74% and 69%, respectively. Median OS was 42.6 months (95% CI: 31-55). Oligometastatic progression occurred in 21/38 patients, and of those, 48% (10/21) received further SBRT. Resulting 2- and 4-year CFS were 47% and 37%, respectively (median 15.1 months). Nineteen patients (37%) experienced a grade 1 or 2 acute toxicity. One grade 3 (acute) toxicity was observed. No grade 4 or 5 toxicities were detected. SBRT to AP OM was associated with sustained LC, excellent OS and minimal toxicity. The use of SBRT allowed for prolonged CFS and the salvage of limited-burden distant failures.
Identifiants
pubmed: 32497405
doi: 10.1111/1754-9485.13057
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
563-569Informations de copyright
© 2020 Royal Australian and New Zealand College of Radiologists.
Références
Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol Off J Am Soc Clin Oncol 1995; 13: 8-10.
Tree AC, Khoo VS, Eeles RA et al. Stereotactic body radiotherapy for oligometastases. Lancet Oncol 2013; 14: e28-37.
Pastorino U, Buyse M, Friedel G et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 1997; 113: 37-49.
Sardenberg RAS, Figueiredo LP, Haddad FJ, Gross JL, Younes RN. Pulmonary metastasectomy from soft tissue sarcomas. Clinics 2010; 65: 871-6.
Simmonds PC, Primrose JN, Colquitt JL, Garden OJ, Poston GJ, Rees M. Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer 2006; 94: 982-99.
Pawlik TM, Choti MA. Surgical therapy for colorectal metastases to the liver. J Gastrointest Surg Off J Soc Surg Aliment Tract 2007; 11: 1057-77.
Selzner M, Morse MA, Vredenburgh JJ, Meyers WC, Clavien PA. Liver metastases from breast cancer: long-term survival after curative resection. Surgery 2000; 127: 383-9.
Tanvetyanon T, Robinson LA, Schell MJ et al. Outcomes of adrenalectomy for isolated synchronous versus metachronous adrenal metastases in non-small-cell lung cancer: a systematic review and pooled analysis. J Clin Oncol Off J Am Soc Clin Oncol 2008; 26: 1142-7.
Benedict SH, Yenice KM, Followill D et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101. Med Phys 2010; 37: 4078-101.
Milano MT, Katz AW, Zhang H, Okunieff P. Oligometastases treated with stereotactic body radiotherapy: long-term follow-up of prospective study. Int J Radiat Oncol Biol Phys 2012; 83: 878-86.
Casamassima F, Livi L, Masciullo S et al. Stereotactic radiotherapy for adrenal gland metastases: university of Florence experience. Int J Radiat Oncol Biol Phys 2012; 82: 919-23.
Kang J-K, Kim M-S, Kim JH et al. Oligometastases confined one organ from colorectal cancer treated by SBRT. Clin Exp Metastasis 2010; 27: 273-8.
Pan H, Simpson DR, Mell LK, Mundt AJ, Lawson JD. A survey of stereotactic body radiotherapy use in the United States. Cancer 2011; 117: 4566-72.
Salama JK, Hasselle MD, Chmura SJ et al. Stereotactic body radiotherapy for multisite extracranial oligometastases: final report of a dose escalation trial in patients with 1 to 5 sites of metastatic disease. Cancer 2012; 118: 2962-70.
Palma DA, Olson R, Harrow S et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET): a randomised, phase 2, open-label trial. Lancet Lond Engl 2019; 393: 2051-8.
Gomez DR, Tang C, Zhang J et al. Local consolidative therapy vs. maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer: long-term results of a multi-institutional, phase II, randomized study. J Clin Oncol 2019; 37: 1558-65.
Loi M, Frelinghuysen M, Klass ND et al. Locoregional control and survival after lymph node SBRT in oligometastatic disease. Clin Exp Metastasis 2018; 35: 625-33.
Rwigema J-CM, King C, Wang P-C et al. Stereotactic body radiation therapy for abdominal and pelvic oligometastases: dosimetric targets for safe and effective local control. Pract Radiat Oncol 2015; 5: e183-91.
Timmerman RD. An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin Radiat Oncol 2008; 18: 215-22.
Eisenhauer EA, Therasse P, Bogaerts J et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 2009; 45: 228-47.
Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457-81.
Bignardi M, Navarria P, Mancosu P et al. Clinical outcome of hypofractionated stereotactic radiotherapy for abdominal lymph node metastases. Int J Radiat Oncol Biol Phys 2011; 81: 831-8.
Choi CW, Cho CK, Yoo SY et al. Image-guided stereotactic body radiation therapy in patients with isolated para-aortic lymph node metastases from uterine cervical and corpus cancer. Int J Radiat Oncol 2009; 74: 147-53.
Yeung R, Hamm J, Liu M, Schellenberg D. Institutional analysis of stereotactic body radiotherapy (SBRT) for oligometastatic lymph node metastases. Radiat Oncol 2017; 12: 105.
McCammon R, Schefter TE, Gaspar LE, Zaemisch R, Gravdahl D, Kavanagh B. Observation of a dose-control relationship for lung and liver tumours after stereotactic body radiation therapy. Int J Radiat Oncol 2009; 73: 112-8.
Onishi H, Shirato H, Nagata Y et al. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol 2007; 2: S94-100.
Lazzari R, Ronchi S, Gandini S et al. Stereotactic body radiation therapy for oligometastatic ovarian cancer: a step toward a drug holiday. Int J Radiat Oncol 2018; 101: 650-60.
Milano MT, Katz AW, Okunieff P. Patterns of recurrence after curative-intent radiation for oligometastases confined to one organ. Am J Clin Oncol 2010; 33: 157-63.