Single Fraction Stereotactic Ablative Body Radiotherapy for Oligometastasis: Outcomes from 132 Consecutive Patients

Gandhidasan, Senthilkumar; Ball, David; Kron, Tomas; Bressel, Mathias; Shaw, Margaret; Chu, Julie; Chander, Sarat; Wheeler, Greg; Plumridge, Nikki; Chesson, Brent; David, Steven; Siva, Shankar

doi:10.1016/j.clon.2017.11.010

Cited by 20 publications

(24 citation statements)

References 14 publications

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“…The DFI may be a good indicator of disease recurrence. Gandhidasan et al reported 132 patients treated with SABR for oligometastasis [7]. In their analysis, a long DFI was significantly associated with favourable recovery from widespread disease (HR: 0.91, 95% CI: 0.82-1.01, p = 0.041).…”

Section: Discussionmentioning

confidence: 97%

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Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: a retrospective study

et al. 2020

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Background: Abdominal/pelvic lymph node (LN) oligometastasis, a pattern of treatment failure, is observed occasionally, and radiotherapy may work as salvage therapy. The optimal prescription dose, however, is yet to be determined. This study assessed the efficacy of high-dose radiotherapy. Methods: The medical records of 113 patients at 4 institutes were retrospectively analysed who had 1 to 5 abdominal/pelvic LN oligometastases and were treated with definitive radiotherapy between 2008 and 2018. The exclusion criteria included non-epithelial tumours, uncontrolled primary lesions, palliative intent, and re-irradiation. The prescription dose was evaluated by using the equivalent dose in 2 Gy fractions (EQD2). Patients receiving EQD2 ≥ 60 Gy were placed into the high-dose group, and the remaining others the low-dose group. Kaplan-Meier analyses were performed to evaluate overall survival (OS), local control (LC), and progression-free survival (PFS). Univariate log-rank and multivariate Cox proportional hazards model analyses were performed to explore predictive factors. Adverse events were compared between the high-dose and low-dose groups. Results: The primary tumour sites included the colorectum (n = 28), uterine cervix (n = 27), endometrium (n = 15), and ovaries (n = 10). The rate of 2-year OS was 63.1%, that of LC 59.7%, and that of PFS 19.4%. On multivariate analyses, OS were significantly associated with solitary oligometastasis (hazard ratio [HR]: 0.48, p = 0.02), LC with high-dose radiotherapy (HR: 0.93, p < 0.001), and PFS with long disease-free interval (HR: 0.59, p = 0.01). Whereas high-dose radiotherapy did not significantly improve 2-year OS in the entire cohort (74.8% in the high-dose vs. 52.7% in the low-dose; p = 0.08), it did in the subgroup of solitary oligometastasis (88.8% in the high-dose vs. 56.3% in the low-dose; p = 0.009). As for Late grade ≥ 3 adverse event, ileus was observed in 7 patients (6%) and gastrointestinal bleeding in 4 (4%). No significant association between the irradiation dose and adverse event incidence was found. Conclusions: As salvage therapy, high-dose radiotherapy was recommendable for oligometastasis in the abdominal/pelvic LNs. For solitary oligometastasis, LC and OS were significantly better in the high-dose group.

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Section: Discussionmentioning

confidence: 97%

“…Along with the increasing use of high-precision irradiation technology, reports regarding the use of high-dose radiotherapy for oligometastasis are also increasing [7,8]. Recently, the SABR-COMET trial, a randomised phase 2 open-label trial, compared radiotherapy and standard of care palliative treatment for oligometastasis [9].…”

Section: Introductionmentioning

confidence: 99%

Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: a retrospective study

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The DFI may be a good indicator of disease recurrence. Gandhidasan et al reported 132 patients treated with SABR for oligometastasis [7]. In their analysis, a long DFI was signi cantly associated with favourable recovery from widespread disease (HR: 0.91, 95% CI: 0.82-1.01, p = 0.041).…”

Section: Discussionmentioning

confidence: 97%

“…Along with the increasing use of high-precision irradiation technology, reports regarding the use of highdose radiotherapy for oligometastasis are also increasing [7,8]. Recently, the SABR-COMET trial, a randomised phase 2 open-label trial, compared radiotherapy and standard of care palliative treatment for oligometastasis [9].…”

Section: Introductionmentioning

confidence: 99%

Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: A retrospective study

Ito

Kodaira

Koide

et al. 2020

Preprint

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Background: Abdominal/pelvic lymph node (LN) oligometastasis, a pattern of treatment failure, is observed occasionally, and radiotherapy may work as salvage therapy. The optimal prescription dose, however, is yet to be determined. This study assessed the efficacy of high-dose radiotherapy.Methods: The medical records of 113 patients at 4 institutes were retrospectively analysed who had 1 to 5 abdominal/pelvic LN oligometastases and were treated with definitive radiotherapy between 2008 and 2018. The exclusion criteria included non-epithelial tumours, uncontrolled primary lesions, palliative intent, and re-irradiation. The prescription dose was evaluated by using the equivalent dose in 2 Gy fractions (EQD2). Patients receiving EQD2 ≥60 Gy were placed into the high-dose group, and the remaining others the low-dose group. Kaplan-Meier analyses were performed to evaluate overall survival (OS), local control (LC), and progression-free survival (PFS). Univariate log-rank and multivariate Cox proportional hazards model analyses were performed to explore predictive factors. Adverse events were compared between the high-dose and low-dose groups.Results: The primary tumour sites included the colorectum (n = 28), uterine cervix (n = 27), endometrium (n = 15), and ovaries (n = 10). The rate of 2-year OS was 63.1%, that of LC 59.7%, and that of PFS 19.4%. On multivariate analyses, OS were significantly associated with solitary oligometastasis (hazard ratio [HR]: 0.48, p = 0.02), LC with high-dose radiotherapy (HR: 0.93, p < 0.001), and PFS with long disease-free interval (HR: 0.59, p = 0.01). Whereas high-dose radiotherapy did not significantly improve 2-year OS in the entire cohort (74.8% in the high-dose vs. 52.7% in the low-dose; p = 0.08), it did in the subgroup of solitary oligometastasis (88.8% in the high-dose vs. 56.3% in the low-dose; p = 0.009). As for Late grade ≥3 adverse event, ileus was observed in 7 patients (6%) and gastrointestinal bleeding in 4 (4%). No significant association between the irradiation dose and adverse event incidence was found.Conclusions: As salvage therapy, high-dose radiotherapy was recommendable for oligometastasis in the abdominal/pelvic LNs. For solitary oligometastasis, LC and OS were significantly better in the high-dose group.

show abstract

“…Along with the increasing use of high-precision irradiation technology, reports regarding the use of high-dose radiotherapy for oligometastasis are also increasing [6,7]. Recently, the SABR-COMET trial, a randomised phase 2 open-label trial, compared radiotherapy and standard of care palliative treatment for oligometastasis [8].…”

Section: Introductionmentioning

confidence: 99%

Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: A retrospective study

Ito

Kodaira

Koide

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Abdominal/pelvic lymph node (LN) oligometastasis is a pattern of failure that is observed occasionally. Although radiotherapy may be useful for salvage therapy, the optimal prescription dose has not yet been clarified. This study assessed the efficacy of high-dose radiotherapy. Methods: Between 2008 and 2018, the medical records of 113 patients with 1–5 abdominal/pelvic LN oligometastases treated with definitive radiotherapy at 4 institutes were retrospectively analysed. The exclusion criteria were non-epithelial tumours, uncontrolled primary lesions, palliative intent, and re-irradiation. The prescription dose was evaluated by using the equivalent dose in 2 Gy fractions (EQD2); patients with EQD2 ≥60 Gy were the high-dose group. Kaplan-Meier analysis was used to evaluate the endpoints of overall survival (OS), local control (LC), and progression-free survival (PFS). Univariate log-rank and multivariate Cox proportional hazards model analyses were performed to clarify predictive factors for each endpoint. Toxicity rates were compared between the high-dose and low-dose groups. Results: The primary tumour sites included the colorectum (n = 28), uterine cervix (n = 27), endometrium (n = 15), and ovaries (n = 10). The 2-year OS, LC, and PFS rates were 63.1%, 59.7%, and 19.4%, respectively. On multivariate analyses, solitary oligometastasis, high-dose radiotherapy, and long disease-free interval were associated with significantly favourable OS (hazard ratio [HR]: 0.48, p = 0.02), LC (HR: 0.93, p < 0.001), and PFS (HR: 0.59, p = 0.01), respectively. Although high-dose radiotherapy did not significantly improve the 2-year OS of the entire cohort (74.8% vs. 52.7% in the high-dose vs. low-dose group; p = 0.08), it showed a significant difference on subgroup analysis for solitary oligometastasis (88.8% vs. 56.3%; p = 0.009). Late grade ≥3 toxicity included ileus in 7 cases (6%) and gastrointestinal bleeding in 4 (4%). There was no significant association between the irradiation dose and toxicity incidence. Conclusions: Salvage radiotherapy was feasible for oligometastasis of the abdominal/pelvic LNs. For solitary oligometastasis, the high-dose group showed favourable results considering LC and OS.

show abstract

Single Fraction Stereotactic Ablative Body Radiotherapy for Oligometastasis: Outcomes from 132 Consecutive Patients

Cited by 20 publications

References 14 publications

Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: a retrospective study

Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: a retrospective study

Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: A retrospective study

Role of high-dose salvage radiotherapy for oligometastases of the localised abdominal/pelvic lymph nodes: A retrospective study

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