Cancer-specific dose and fractionation schedules in stereotactic body radiotherapy for oligometastatic disease: An interim analysis of the EORTC-ESTRO E

Fractionation Oligometastasis Radiation dose SBRT

Journal

Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
ISSN: 1879-0887
Titre abrégé: Radiother Oncol
Pays: Ireland
ID NLM: 8407192

Informations de publication

Date de publication:
18 Mar 2024
Historique:
received: 01 10 2023
revised: 12 03 2024
accepted: 14 03 2024
medline: 21 3 2024
pubmed: 21 3 2024
entrez: 20 3 2024
Statut: aheadofprint

Résumé

Optimal dose and fractionation in stereotactic body radiotherapy (SBRT) for oligometastatic cancer patients remain unknown. In this interim analysis of OligoCare, we analyzed factors associated with SBRT dose and fractionation. Analysis was based on the first 1,099 registered patients. SBRT doses were converted to biological effective doses (BED) using α/β of 10 Gy for all primaries, and cancer-specific α/β of 10 Gy for non-small cell lung and colorectal cancer (NSCLC, CRC), 2.5 Gy for breast cancer (BC), or 1.5 Gy for prostate cancer (PC). Of the interim analysis population of 1,099 patients, 999 (99.5 %) fulfilled inclusion criteria and received metastasis-directed SBRT for NSCLC (n = 195; 19.5 %), BC (n = 163; 16.3 %), CRC (n = 184; 18.4 %), or PC (n = 457; 47.5 %). Two thirds of patients were treated for single metastasis. Median number of fractions was 5 (IQR, 3-5) and median dose per fraction was 9.7 (IQR, 7.7-12.4) Gy. The most frequently treated sites were non-vertebral bone (22.8 %), lung (21.0 %), and distant lymph node metastases (19.0 %). On multivariate analysis, the dose varied significantly for primary cancer type (BC: 237.3 Gy BED, PC 300.6 Gy BED, and CRC 84.3 Gy BED), and metastatic sites, with higher doses for lung and liver lesions. This real-world analysis suggests that SBRT doses are adjusted to the primary cancers and oligometastasis location. Future analysis will address safety and efficacy of this site- and disease-adapted SBRT fractionation approach (NCT03818503).

Sections du résumé

BACKGROUND AND INTRODUCTION BACKGROUND
Optimal dose and fractionation in stereotactic body radiotherapy (SBRT) for oligometastatic cancer patients remain unknown. In this interim analysis of OligoCare, we analyzed factors associated with SBRT dose and fractionation.
MATERIALS AND METHODS METHODS
Analysis was based on the first 1,099 registered patients. SBRT doses were converted to biological effective doses (BED) using α/β of 10 Gy for all primaries, and cancer-specific α/β of 10 Gy for non-small cell lung and colorectal cancer (NSCLC, CRC), 2.5 Gy for breast cancer (BC), or 1.5 Gy for prostate cancer (PC).
RESULTS RESULTS
Of the interim analysis population of 1,099 patients, 999 (99.5 %) fulfilled inclusion criteria and received metastasis-directed SBRT for NSCLC (n = 195; 19.5 %), BC (n = 163; 16.3 %), CRC (n = 184; 18.4 %), or PC (n = 457; 47.5 %). Two thirds of patients were treated for single metastasis. Median number of fractions was 5 (IQR, 3-5) and median dose per fraction was 9.7 (IQR, 7.7-12.4) Gy. The most frequently treated sites were non-vertebral bone (22.8 %), lung (21.0 %), and distant lymph node metastases (19.0 %). On multivariate analysis, the dose varied significantly for primary cancer type (BC: 237.3 Gy BED, PC 300.6 Gy BED, and CRC 84.3 Gy BED), and metastatic sites, with higher doses for lung and liver lesions.
CONCLUSION CONCLUSIONS
This real-world analysis suggests that SBRT doses are adjusted to the primary cancers and oligometastasis location. Future analysis will address safety and efficacy of this site- and disease-adapted SBRT fractionation approach (NCT03818503).

Identifiants

pubmed: 38508239
pii: S0167-8140(24)00157-9
doi: 10.1016/j.radonc.2024.110235
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT03818503']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110235

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: BAJF received grants from Accuray, AIRC, IBA and Fondazione IEO-CCM, lecture payments/honoraria from Bayer, Accuray, Astellas, IBA, IPSEN, Astra Zeneca, Tecnologie Avanzate, Recordati, and Novartis, and has board appointments at Astra Zeneca, Bayer, and Seagen. MG and PO are PIs of the ESTRO-EORTC 1811-E²-RADIatE OligoCare trial. MG is president-elect of ESTRO.

Auteurs

Sebastian M Christ (SM)

Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland. Electronic address: sebastian.christ@usz.ch.

Filippo Alongi (F)

IRCCS Sacro Cuore Don Calabria Hospital, Advanced Radiation Oncology Department, Negrar-Verona, Italy & University of Brescia, Brescia, Italy.

Umberto Ricardi (U)

University of Turin, Department of Oncology, Turin, Italy.

Marta Scorsetti (M)

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy; Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano 20089, Milan, Italy.

Lorenzo Livi (L)

Azienda Ospedaliero-Universitaria Careggi, Radiation Oncology, Florence, Italy.

Panagiotis Balermpas (P)

Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Yolande Lievens (Y)

Radiation Oncology Department, Ghent University Hospital and University, Ghent, Belgium.

Pètra Braam (P)

Radboud University Medical Center Nijmegen, Radiation Oncology, Nijmengen, the Netherlands.

Barbara Alicja Jereczek-Fossa (B)

Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy; Department of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy.

Karin Stellamans (K)

Campus Kennedylaan, AZ Groeninge Kortrijk, Kortrijk, Belgium.

Ivica Ratosa (I)

Division of Radiotherapy, Institute of Oncology Ljubljana, Ljubljana, Slovenia & Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Joachim Widder (J)

Department of Radiation Oncology, Comprehensive Cancer Center, University Hospital Vienna, Medical University of Vienna, Austria.

Heike Peulen (H)

Catharina Hospital, Radiation Oncology, Eindhoven, the Netherlands.

Piet Dirix (P)

Iridium Network, Radiation Oncology, Wilrijk, Belgium.

Samuel Bral (S)

Onze-Lieve-Vrouw Ziekenhuis, Radiation Oncology, Aalst, Belgium.

Sara Ramella (S)

Policlinico Universitario Campus Bio-Medico-Oncology Center, Radiation Oncology, Roma, Italy.

Hossein Hemmatazad (H)

Department of Radiation Oncology, Inselspital, Bern University Hospital and University of Bern, Switzerland.

Kaouthar Khanfir (K)

Hopital de Sion, Hopital du Valais, Radiation Oncology, Sion, Switzerland.

Xavier Geets (X)

Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Paul Jeene (P)

Radiotherapiegroep, Deventer, the Netherlands.

Thomas Zilli (T)

Hôpitaux Universitaires de Genève (HUG), site de Cluse-Roseraie, Radiation Oncology, Geneva, Switzerland.

Beatrice Fournier (B)

European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium.

Giovanni Battista Ivaldi (G)

Department of Radiation Oncology, Istituti Clinici Scientifici Maugeri, IRCCS, Pavia, Italy.

Enrico Clementel (E)

European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium.

Catherine Fortpied (C)

European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium.

Felix Boakye Oppong (F)

European Organisation for Research and Treatment of Cancer (EORTC), Headquarters, Brussels, Belgium.

Piet Ost (P)

Iridium Network, Radiation Oncology, Wilrijk, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium.

Matthias Guckenberger (M)

Department of Radiation Oncology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.

Classifications MeSH