Stereotactic radiotherapy for liver oligometastases: a pooled analysis following the estro/eortc consensus recommendations.

Liver metastases Oligometastasis Oligorecurrences Stereotactic body radiotherapy Stereotactic radiosurgery

Journal

Clinical & experimental metastasis
ISSN: 1573-7276
Titre abrégé: Clin Exp Metastasis
Pays: Netherlands
ID NLM: 8409970

Informations de publication

Date de publication:
17 Jul 2024
Historique:
received: 04 03 2024
accepted: 08 07 2024
medline: 17 7 2024
pubmed: 17 7 2024
entrez: 17 7 2024
Statut: aheadofprint

Résumé

A large pooled analysis of liver oligometastases, classified accordingly to the ESTRO/EORTC recommendations, treated by stereotactic radiotherapy (SBRT) and Radiosurgery (SRS) was carried out. The clinical and dosimetric data of patients who underwent SBRT/SRS for liver metastases were analysed in terms of efficacy and toxicity profile. In particular, the Local Control (LC), the Distant Metastases Free Survival (DMFS), the Disease-Free Survival (DFS), the Overall Survival (OS), and the Next Systemic Therapy Free Survival (NEST-FS) rates were analysed. 113 patients (M/F: 49/64), accounting for a total of 150 hepatic lesions (March 2006-February 2023) in two Italian radiotherapy Institutions were evaluated. Median age was 67 years old (36-92) and 48 (42.5%) patients had at least one comorbidity. The majority of the lesions were induced (30.7%) or repeated oligoprogressive (12.7%) metastases. 98 lesions were treated with more than one daily fraction (mainly 50 Gy in 5 fractions), while 52 were radiosurgery treatments (mainly 32 Gy). The treatment response at 3-4 months was evaluable in 147 lesions: complete response was 32.0%, partial response 17.0%, and stable disease 32.0%. Actuarial LC, DMFS, DFS, OS, and NEST-FS at 1 year were 75.8%, 37.7%, 34.9%, 78.7%, and 59.4% respectively; while actuarial LC, DMFS, DFS, OS, and NEST-FS at 2 years were 52.1%, 24.9%, 21.9%, 51.3%, and 36.8%, respectively. The achievement of complete response, synchronous oligometastases, and no treatment interruptions correlated with a more favorable outcomes. As per the toxicity profile, we registered only two acute and one late toxicity cases higher than grade 2. Stereotactic treatment for liver metastases seems to be a safe and promising option in terms of local control. The best results in term of outcomes have been obtained in patients with complete response, synchronous oligometastases, favorable histology, and no treatment interruptions.

Identifiants

pubmed: 39017807
doi: 10.1007/s10585-024-10301-6
pii: 10.1007/s10585-024-10301-6
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer Nature B.V.

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Auteurs

D Pezzulla (D)

Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy.

G Chiloiro (G)

UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, San Giovanni Rotondo, Italy.

E M Lima (EM)

UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, San Giovanni Rotondo, Italy.

G Macchia (G)

Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy. macchiagabriella@gmail.com.

C Romano (C)

Medical Physics Unit, Responsible Research Hospital, Campobasso, Italy.

S Reina (S)

UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, San Giovanni Rotondo, Italy.

G Panza (G)

UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, San Giovanni Rotondo, Italy.

S Cilla (S)

Medical Physics Unit, Responsible Research Hospital, Campobasso, Italy.

A G Morganti (AG)

Radiation Oncology, Department of Experimental, Diagnostic and Specialty Medicine - DIMES, IRCCS Azienda Ospedaliero, Universitaria di Bologna - Alma Mater Studiorum University of Bologna, Bologna, Italy.

F Cellini (F)

UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, San Giovanni Rotondo, Italy.
Istituto di Radiologia, Università Cattolica del Sacro Cuore, Milano, Italy.

M A Gambacorta (MA)

UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, San Giovanni Rotondo, Italy.
Istituto di Radiologia, Università Cattolica del Sacro Cuore, Milano, Italy.

F Deodato (F)

Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Italy.
Istituto di Radiologia, Università Cattolica del Sacro Cuore, Milano, Italy.

Classifications MeSH