30 Gy single dose stereotactic body radiation therapy (SBRT): Report on outcome in a large series of patients with lung oligometastatic disease.
Lung Cancer
; 122: 165-170, 2018 08.
Article
em En
| MEDLINE
| ID: mdl-30032826
ABSTRACT
OBJECTIVES:
To evaluate the local control (LC) and long term adverse effects in a series of patients with lung metastases who received 30â¯Gy in single dose with stereotactic technique. MATERIALS ANDMETHODS:
Between December 2008 and April 2016, a total of 166 lung metastases in 129 patients affected by oligometastatic disease were treated at our Institution with stereotactic body radiotherapy (SBRT). Mainly, the primary tumors were non small-cell lung cancer and colorectal cancer (45.2% and 28.8%, respectively). Prognostic factors were also assessed.RESULTS:
The median follow-up was 38 months. Local progression occurred in 24 (14.4%) lesions in 21 patients. Intra-thoracic progression (new lung lesions or thoracic lymph node metastases) occurred in 59 (45.7%) patients. Forty-five (34.8%) patients had distant progression after a median time of 14 months. The 3- and 5-years local relapse-free survival (LPFS) were 80.1% and 79.2% (median not reached), respectively. One-hundred forty-eight patients were evaluated for late toxicity (follow-up >6 months) 51 (34.4%) patients had grade ≤2 fibrosis, 11 (7.4%) patients experienced grade 3 fibrosis. Two (1.3%) cases of rib fracture occurred. One case of toxic death (grade 5) has been reported. Median OS was 39 months. At the univariate analysis, lesion diameter ≤18â¯mm correlated significantly with a longer LPFS (pâ¯=â¯0.001). At the multivariate analysis, lesion diameter <18â¯mm was predictive for longer LPFS (pâ¯=â¯0.006). Also, oligometastases from primary colorectal cancer was a significant predictive factor for worse LPFS (pâ¯=â¯0.041) and progression-free survival (pâ¯=â¯0.04).CONCLUSIONS:
To our knowledge, the current study represents the largest series on the use of SBRT 30â¯Gy single dose for lung metastases. Our results confirm the effectiveness and safety of this schedule administered in selected oligometastatic patients. Further prospective series could better validate these results.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
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Radiocirurgia
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Carcinoma Pulmonar de Células não Pequenas
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Pulmão
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Neoplasias Pulmonares
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Lung Cancer
Assunto da revista:
NEOPLASIAS
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Itália