Pulmonary Oligometastases Treated by Stereotactic Body Radiation Therapy: A Nationwide Survey of 1,378 Patients

Abstract

Aim: This study was performed to confirm the superior overall survival (OS) after pulmonary oligo-recurrence compared to pulmonary sync-oligometastases in a large nationwide study. Patients and Methods: Patients that met the following criteria were included: 1 to 5 lung-only metastases at the beginning of stereotactic body radiation therapy (SBRT) was performed between January 2004 and June 2015, and the biological effective dose (BED) of SBRT was 75 Gy or more. The parameters included in the analyses were age, gender, ECOG PS, primary lesion, pathology, oligoetastatic state, SBRT date, chemotherapy before SBRT, chemotherapy concurrent SBRT, chemotherapy after SBRT, maximum tumor diameter, number of metastases, field coplanarity, dose prescription, BED 10 , OTT of SBRT. Results: In total, 1,378 patients with 1,547 tumors were enrolled. Oligo-recurrence occurred in 1,016 patients, sync-oligometastases in 118, and unclassified oligometastases in 121. The three-year OS was 64.0% for oligorecurrence and 47.5% for sync-oligometastasis (p<0.001). In the multivariate analysis, the hazard ratio (HR) for syncoligometastases versus oligo-recurrence was 1.601 (p=0.014). Adverse events of Grade 5 were occurred in 3 patients. Conclusion: This is the first nationwide to indicate that the OS 393

Analyses of the local control of pulmonary Oligometastases after stereotactic body radiotherapy and the impact of local control on survival

“…Analyses of pretreatment prognostic factors for OS (the primary endpoint) have been previously reported elsewhere [13]. In this study, LC analyses were performed as secondary endpoint analyses, and the impact of LC on survival was determined by exploratory survival analyses.…”

Analyses of Local Control of Pulmonary Oligometastases after Stereotactic Body Radiotherapy and Impact of Local Control on Survival

“…Analyses of pretreatment prognostic factors for OS (primary endpoint) were reported elsewhere [13]. Because local failure was observed factor after SBRT, further analysis of OS was performed in this study to determine the effect of LC on OS.…”

“…Oligometastases have been classi ed into oligo-recurrences and sync-oligometastases according to the activity of the primary lesion at the time of initial appearance of oligometastases and patients with oligorecurrences had longer survival [11,12]. Recently, an investigation to determine whether there is a survival difference between patients with pulmonary oligo-recurrences and patients with sync-oligometastases after control of the primary lesion was performed in Japan and it was shown that patients with oligorecurrences had a survival advantage [13]. The next question is whether successful local therapy for pulmonary oligometastases leads to longer survival or not and what factors affected local control (LC).…”

Analyses of the Local Control of Pulmonary Oligometastases after Stereotactic Body Radiotherapy and the Impact of Local Control on Survival

“…Oligometastases have been classi ed into oligorecurrences and sync-oligometastases according to the activity of the primary lesion at the time of the initial appearance of oligometastases, and patients with oligo-recurrences have longer survival than those with sync-oligometastases [11,12]. Recently, an investigation to determine whether there is a survival difference between patients with pulmonary oligo-recurrences and patients with syncoligometastases after establishing control of the primary lesion was performed in Japan, and it was shown by our group that patients with oligo-recurrences had a survival advantage compared with those with sync-oligometastases [13]. The next question is whether successful local therapy for pulmonary oligometastases leads to longer survival or not and what factors affect local control (LC).…”