Lung metastases treated with stereotactic body radiotherapy: the RSSearch® patient Registry’s experience

Ricco, Anthony; Davis, Joanne; Rate, William; Yang, Jun; Perry, David; Pablo, John; D’Ambrosio, David J.; Sharma, Shubham; Sundararaman, Srinath; Kolker, James D.; Creach, Kimberly M.; Lanciano, Rachelle

doi:10.1186/s13014-017-0773-4

Cited by 75 publications

(67 citation statements)

References 31 publications

(36 reference statements)

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“…Ricco et al analyzed whether different lung metastases volume and BED were associated with treatment outcomes (17). In this study, lesions after SBRT with BED ≥100 Gy reached better LC rates.…”

Section: Discussionmentioning

confidence: 71%

Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases

Kalinauskaitė

Tinhofer

Kufeld

et al. 2019

Preprint

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Background: Patients with oligometastatic disease can potentially be cured by using an ablative therapy for all active lesions. Stereotactic body radiotherapy (SBRT) is a non-invasive treatment option that lately proved to be as effective and safe as surgery in treating lung metastases (LM).However, it is not clear which patients benefit most and what are the most suitable fractionation regimes. The aim of this study was to analyze treatment outcomes after single fraction radiosurgery (SFRS) and fractionated SBRT (fSBRT) in patients with lung oligometastases and identify prognostic clinical features for better survival outcomes. Methods: Fifty-two patients with 94 LM treated with SFRS or fSBRT between 2010 and 2016 were analyzed. The characteristics of primary tumor, LM, treatment, toxicity profiles and outcomes were assessed. Kaplan-Meier and Cox regression analyses were used for estimation of local control (LC), overall survival (OS), progression free survival and distant metastases free survival (DMFS). Results: Ninety-four LM in 52 patients were treated using SFRS/fSBRT with a median of 2 lesions per patient (range: 1-5). The median planning target volume (PTV)-encompassing dose for SFRS was 24 Gy (range: 17-26) compared to 45 Gy (range: 20-60) in 2-12 fractions in fSBRT. The median follow-up time was 21 months (range: 3-68). LC rates at 1 and 2years for SFSR vs. fSBRT were 89% and 83% vs. 75% and 59%, respectively (p=0.026). LM treated with SFSR were significantly smaller (p=0.001). The 1 and 2-year OS rates for all patients were 84% and 71%, respectively. In univariate analysis treatment with SFRS, an interval of ≥ 12 months between diagnosis of LM and treatment, non-colorectal cancer histology and BED <100 Gy were significantly associated with better LC. However, none of these parameters remained significant in the multivariate Cox regression model. OS was significantly better in patients with negative lymph nodes (N0), Karnofsky performance status (KPS) >70% and time to first metastasis ≥12 months. There was no grade 3 acute or late toxicity. Conclusions: We observed good LC and low toxicity rates after SFRS for small lung metastases. Longer time to first metastasis, good KPS and N0 predicted better OS. BackgroundMetastatic progression of cancer is linked to poor prognosis and is the leading cause of cancer-related deaths (1). Few decades ago, the diagnosis of metastatic disease was related with lethal outcomes.

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Section: Discussionmentioning

confidence: 71%

Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases

Kalinauskaitė

Tinhofer

Kufeld

et al. 2019

Preprint

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“…These patients may be able to better tolerate endocrine therapy and targeted therapy; in addition, radiotherapy and local surgery have also been shown to provide better control for bone and lung metastases. [33][34][35] Although, patients HER2+ subtype were more prone to liver metastases, which may benefit from combined HER2 targeted therapy. However, liver metastases may be regarded as a sign of systemic tumor spread, which is amenable to targeted therapy or systemic chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

The effect of distant metastases sites on survival in de novo stage-IV breast cancer: A SEER database analysis

Li²,

Tang

et al. 2017

Tumour Biol.

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To investigate the effect of distant metastases sites on survival in patients with de novo stage-IV breast cancer. From 2010 to 2013, patients with a diagnosis of de novo stage-IV breast cancer were identified using the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox regression analyses were performed to analyze the effect of distant metastases sites on breast cancer-specific survival and overall survival. A total of 7575 patients were identified. The most common metastatic sites were bone, followed by lung, liver, and brain. Patients with hormone receptor+/human epidermal growth factor receptor 2- and hormone receptor+/human epidermal growth factor receptor 2+ status were more prone to bone metastases. Lung and brain metastases were common in hormone receptor-/human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2- subtypes, and patients with hormone receptor+/ human epidermal growth factor receptor 2+ and hormone receptor-/human epidermal growth factor receptor 2+ subtypes were more prone to liver metastases. Patients with liver and brain metastases had unfavorable prognosis for breast cancer-specific survival and overall survival, whereas bone and lung metastases had no effect on patient survival in multivariate analyses. The hormone receptor-/human epidermal growth factor receptor 2- subtype conferred a significantly poorer outcome in terms of breast cancer-specific survival and overall survival. hormone receptor+/human epidermal growth factor receptor 2+ disease was associated with the best prognosis in terms of breast cancer-specific survival and overall survival. Patients with liver and brain metastases were more likely to experience poor prognosis for breast cancer-specific survival and overall survival by various breast cancer subtypes. Distant metastases sites have differential impact on clinical outcomes in stage-IV breast cancer. Follow-up screening for brain and liver metastases might be effective in improving breast cancer-specific survival and overall survival.

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“…Ricco et al analyzed whether different lung metastases volumes and BED were associated with treatment outcomes (17). In this study, lesions after SBRT with BED ≥100 Gy reached better LC rates.…”

Section: Discussionmentioning

confidence: 72%

Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases

Kalinauskaitė

Tinhofer

Kufeld

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Patients with oligometastatic disease can potentially be cured by using an ablative therapy for all active lesions. Stereotactic body radiotherapy (SBRT) is a non-invasive treatment option that lately proved to be as effective and safe as surgery in treating lung metastases (LM). However, it is not clear which patients benefit most and what are the most suitable fractionation regimens. The aim of this study was to analyze treatment outcomes after single fraction radiosurgery (SFRS) and fractionated SBRT (fSBRT) in patients with lung oligometastases and identify prognostic clinical features for better survival outcomes. Methods: Fifty-two patients with 94 LM treated with SFRS or fSBRT between 2010 and 2016 were analyzed. The characteristics of primary tumor, LM, treatment, toxicity profiles and outcomes were assessed. Kaplan-Meier and Cox regression analyses were used for estimation of local control (LC), overall survival (OS) and progression-free survival.Results: Ninety-four LM in 52 patients were treated using SFRS/fSBRT with a median of 2 lesions per patient (range: 1–5). The median planning target volume (PTV)-encompassing dose for SFRS was 24 Gy (range: 17-26) compared to 45 Gy (range: 20-60) in 2-12 fractions in fSBRT. The median follow-up time was 21 months (range: 3-68). LC rates at 1 and 2 years for SFSR vs. fSBRT were 89% and 83% vs. 75% and 59%, respectively (p=0.026). LM treated with SFSR were significantly smaller (p=0.001). The 1 and 2-year OS rates for all patients were 84% and 71%, respectively. In univariate analysis treatment with SFRS, an interval of ≥ 12 months between diagnosis of LM and treatment, non-colorectal cancer histology and BED <100 Gy were significantly associated with better LC. However, none of these parameters remained significant in the multivariate Cox regression model. OS was significantly better in patients with negative lymph nodes (N0), Karnofsky performance status (KPS) >70% and time to first metastasis ≥12 months. There was no grade 3 acute or late toxicity. Conclusions: Longer time to first metastasis, good KPS and N0 predicted better OS. Good LC and low toxicity rates were achieved after short SBRT schedules.

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Lung metastases treated with stereotactic body radiotherapy: the RSSearch® patient Registry’s experience

Cited by 75 publications

References 31 publications

Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases

Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases

The effect of distant metastases sites on survival in de novo stage-IV breast cancer: A SEER database analysis

Radiosurgery and fractionated stereotactic body radiotherapy for patients with lung oligometastases

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