Long-term survival following definitive radiation therapy for recurrence or oligometastases in gynecological malignancies: A landmark analysis

Corrigan, Kelsey L.; Yoder, Alison; De, Brian; Lin, Lilie L.; Jhingran, Anuja; Joyner, Melissa; Eifel, Patricia J.; Colbert, Lauren E.; Lu, Karen H.; Klopp, Ann H.

doi:10.1016/j.ygyno.2021.12.022

Cited by 7 publications

(6 citation statements)

References 20 publications

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“…Most patients have distant metastases at the time of diagnosis, thus losing the window of complete cure [ 1 – 4 ]. The idea of oligometastases was first proposed in 1995 [ 5 ], which believed that cancer in this stage was only limited to one or a few targeted metastases. At present, there is no standard for the definition of oligometastases, but the European Society of Oncology and some recent studies believe that as long as the location of the metastases and the number of metastatic tissues (< 5), oligometastases can be confirmed by a complete radiological examination [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Camrelizumab and Apatinib Combined with Radiotherapy Is Effective in Advanced Oligometastatic Non-Small-Cell Lung Cancer

Song

Lin

2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To investigate the effect of camrelizumab + apatinib combined with radiotherapy on the expression of TRIM27, SCC-Ag, and CYFRA21-1 in advanced oligometastatic non-small-cell lung cancer (NSCLC). Methods. A retrospective analysis of patients with oligometastatic NSCLC who were treated at our hospital from January 1, 2021, to March 31, 2022. Patients who met the inclusion criteria were summarized into an observation group (camrelizumab on the basis of the control group), or a control group (radiotherapy combined with oral apatinib). The disease control rate, immune function, changes in the levels of TRIM27, SCC-Ag, CYFRA21-1, and the occurrence of adverse effects were compared between the two groups. Result. There were 86 patients who met the inclusion criteria, with 53 cases in the observation group and 33 cases in the control group. There were significant differences in complete remission (CR, 25/53 vs. 10/33), partial remission (PR, 17/53 vs. 12/33), disease control (DC, 7/53 vs. 4/33), disease progression (DP, 4/53 vs. 7/33), and disease control rate (49/53 vs. 26/33) between the observation group and the control group. There was no significant difference in immune function between the two groups before treatment ( p > 0.05 ). After treatment, the levels of CD3+, CD4+, CD4+/CD8+t cells, and NK cells in the observation group were higher ( p = 0.015 , 0.035, 0.003, 0.001, respectively), while the level of CD8+t cells was lower ( p < 0.001 ). There were no significant differences in TRIM27, SCC-Ag, or CYFRA21-1 between the two groups before treatment ( p > 0.05 ). After treatment, the observation group had lower levels of TRIM27 ( p = 0.035 ), SCC-Ag ( p = 0.045 ), and CYFRA21-1 ( p = 0.003 ). There was no significant difference in the occurrence of adverse events between the two groups ( p < 0.05 ). Conclusion. Treatment of camrelizumab + apatinib combined with radiotherapy is effective for advanced oligometastatic NSCLC, with mild adverse effects.

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Section: Introductionmentioning

confidence: 99%

Camrelizumab and Apatinib Combined with Radiotherapy Is Effective in Advanced Oligometastatic Non-Small-Cell Lung Cancer

Song

Lin

2022

Evidence-Based Complementary and Alternative Medicine

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“…As for uterine cancer, most of the current data regarding uterine primary oligometastases are from retrospective studies with mixed cohorts [ 21 , 22 , 26 , 27 , 28 , 29 , 30 ]. The only recent study to our knowledge that exclusively included uterine primary oligometastases treated with SBRT is a single-institution retrospective analysis including 27 patients with 61 biopsy-proven lesions [ 20 ].…”

Section: Sbrt In Non-ovarian Gynecologic Primary Oligometastasesmentioning

confidence: 99%

“…Given the high rate of disease progression outside of the SBRT field, elective nodal radiotherapy as metastasis-directed treatment was evaluated in a recently published landmark analysis [ 26 ], with a median follow up of 11.7 years. Definitive standard fractionation 2D/3D conformal radiation therapy (CRT) or IMRT including the entire at-risk nodal echelon was delivered to 48 patients with gynecologic oligometastases, resulting in disease-free survival and overall survival of 73 months and 200 months, respectively.…”

Section: Sbrt In Non-ovarian Gynecologic Primary Oligometastasesmentioning

confidence: 99%

“…Further research and technological advances in precision delivery of higher BEDs, while maintaining OAR constraints, could theoretically lead to increased rates and duration of local control, but the effect on overall survival from out-of-field progression is still unknown. Many studies report that SBRT is very well tolerated, with predominantly mild grade 1–2 gastrointestinal-related toxicities [ 13 , 14 , 17 , 18 , 22 , 26 , 27 , 28 , 29 ]. Grade 3–4 toxicities were noted in 2.6–10% of patients within 7/16 studies in the systematic review by Yegya-Raman et al [ 12 ] that reported grade > 3 toxicities, and no grade 5 toxicities were reported.…”

Section: Novel Techniques Dose Escalation and Safety In Sbrtmentioning

confidence: 99%

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Stereotactic Body Radiation Therapy in Gynecologic Oligometastases: An Effective but Underutilized Approach

Sherwani

Parikh

Yegya-Raman

et al. 2023

Cancers

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Historically, the role of radiation in gynecological metastatic disease involved palliation for pain or bleeding. Stereotactic Body Radiation Therapy (SBRT) has shown survival benefits in oligometastatic disease from varying primary histologies in recent randomized trials. However, gynecologic primary oligometastases have been underrepresented in these trials. Recent studies across gynecological malignancy types have similarly shown favorable outcomes and acceptable toxicities from treating recurrent or oligometastatic gynecologic cancer (ROMGC) patients with definitive radiation therapy. The largest body of literature reported on the use of SBRT in ovarian cancer, which was found to be an effective option, especially in the setting of chemo-resistant disease. Despite the encouraging outcomes using SBRT in oligometastatic gynecologic malignancies, SBRT remains underutilized given the lack of randomized studies studying ROMGC with long term follow-up. While waiting for future prospective trials to establish the role of SBRT as the standard of care in ROMGC patients, this review focuses on reporting the advantages and drawbacks of this technique and examines the current literature to help guide patient centered treatment decisions.

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“…While some series [17] , [18] have included a small number of axillary targets in their SBRT analyses, there are very limited published data on outcomes, toxicities and techniques for specifically treating this region of the body. We conducted a retrospective review of our institutional SBRT experience for AM, focusing on outcomes, safety, and process.…”

Section: Introductionmentioning

confidence: 99%

Uncovering the armpit of SBRT: An institutional experience with stereotactic radiation of axillary metastases

Mutsaers,

Li,

Fernandes

et al. 2024

Clinical and Translational Radiation Oncology

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Long-term survival following definitive radiation therapy for recurrence or oligometastases in gynecological malignancies: A landmark analysis

Cited by 7 publications

References 20 publications

Camrelizumab and Apatinib Combined with Radiotherapy Is Effective in Advanced Oligometastatic Non-Small-Cell Lung Cancer

Camrelizumab and Apatinib Combined with Radiotherapy Is Effective in Advanced Oligometastatic Non-Small-Cell Lung Cancer

Stereotactic Body Radiation Therapy in Gynecologic Oligometastases: An Effective but Underutilized Approach

Uncovering the armpit of SBRT: An institutional experience with stereotactic radiation of axillary metastases

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