Stereotactic ablative radiation therapy for pulmonary metastases: Improving overall survival and identifying subgroups at high risk of local failure

Pasalic, Dario; Lü, Yi; Betancourt-Cuellar, Sonia L.; Taku, Nicolette; Mesko, Shane; Bagley, Alexander F.; Chance, William W.; Allen, Pamela K.; Tang, Chad; Antonoff, Mara B.; Balter, Peter A; Mehran, Reza J.; Welsh, James W.; Liao, Zhongxing; Gomez, Daniel R.; Erasmus, Jeremy J.; Nguyen, Quynh Nhu

doi:10.1016/j.radonc.2020.01.010

Cited by 22 publications

(18 citation statements)

References 34 publications

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“…39 Several larger retrospective analyses have also been reported, including one report from MD Anderson of 406 pulmonary metastases from several types of primary tumors treated with SABR to doses of 40-50 Gy in 4 fractions (for peripheral disease) or 70 Gy in 10 fractions (for central disease). 40 In that study, SABR for pulmonary metastases from adrenal, colorectal, sarcoma, or pancreatic primaries resulted in higher local failure rates (4.6%) compared with metastases from other primaries (4.6% vs 1.6% at 1 year; 12.8% vs 3.9% at 2 years). Overall survival also depended on number of pulmonary metastases, being higher for patients with up to 3 pulmonary metastases than for patients with more than 3 (74.2% vs 59.3% at 2 years; 47.7% vs 35.1% at 4 years).…”

Section: Role Of Stereotactic Ablative Body Radiation For Pulmonary Metastasesmentioning

confidence: 85%

“…This large series of patients with pulmonary metastases from different primary histology experienced excellent local control with SABR and little toxicity. 40 Another review from the German Working Group considered prognostic factors influencing survival and local control in a multi-institutional database of 700 patients with inoperable disease and pulmonary metastases from a variety of primary types; SABR was delivered to doses of 24-30 Gy, either in single fractions or in 5 to 8 fractions, with biologically effective doses of more than 100 Gy. The overall survival for all patients in that study was 75.1% at 1 year and 54.4% at 2 years; local control rates were highest for patients whose primaries were CRC or breast cancer (90.9% at 1 year and 81.2% at 2 years).…”

Section: Role Of Stereotactic Ablative Body Radiation For Pulmonary Metastasesmentioning

confidence: 99%

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The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

Antonoff

Sofocleous

Callstrom

et al. 2022

The Journal of Thoracic and Cardiovascular Surgery

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Section: Role Of Stereotactic Ablative Body Radiation For Pulmonary Metastasesmentioning

confidence: 85%

Section: Role Of Stereotactic Ablative Body Radiation For Pulmonary Metastasesmentioning

confidence: 99%

The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

Antonoff

Sofocleous

Callstrom

et al. 2022

The Journal of Thoracic and Cardiovascular Surgery

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“… 7 Nevertheless, this percentage could be underestimated after recent publications suggested that oligometastatic patients show an increased overall survival benefit when irradiated. 8 - 10 , 20 Thus, we can estimate that each year, there will be approximately 21,890 new patients with lung cancer requiring RT. In 2016, 823 million USD were spent on lung cancer in Brazil, with mortality rates of approximately 80% 21 and 64,000 lung cancer–related deaths in Latin America each year.…”

Section: Discussionmentioning

confidence: 99%

Access of Patients With Lung Cancer to High Technology Radiation Therapy in Brazil

Faroni

Rosa²,

Aran

et al. 2021

JCO Global Oncology

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PURPOSE Lung cancer is a global health problem, with more than 220,000 new cases and 150,000 deaths per year in the United States. Likewise, in Brazil, lung cancer is the most lethal cancer with 30,200 new cases expected in 2020. Regarding treatment types, radiation therapy (RT) represents an important approach, since 60%-70% of the patients will receive this modality of treatment during the course of their disease. However, access to RT remains challenging because of the socioeconomic inequalities in the Brazilian population, where approximately 100,000 patients/year die without access to RT. This work provides an overview on the availability of high technology RT in Brazil. METHODS A retrospective study was performed using the Brazilian Radiotherapy Census, local public and private databases, and the current literature published in 2019. RESULTS The Brazilian radiotherapy network relies on approximately 363 linear accelerators and 20 cobalt machines that remain operational. Most of these machines are installed at public health facilities. Regarding high technology, intensity-modulated RT is available in 53.7% (n = 130) and volumetric modulated arc therapy in 28.5% (n = 69) of the institutions, although only 19.8% (n = 48) of those facilities are capable of performing image-guided RT using cone beam computed tomography. Considering only the public health care system, the scenario is more restricted, with 40.1% (n = 65) of the institutions offering intensity-modulated RT, 21% (n = 34) volumetric modulated arc therapy, and 14.8% (n = 24) using cone beam computed tomography. Because of these scare resources, only 16% of Radiation Departments offer stereotactic body RT. CONCLUSION Brazil still needs to improve and provide high and safer RT technologies to patients with lung cancer across all Brazilian regions to attend the population needs and obtain better patient outcomes.

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“…Several groups have integrated SBRT into the multimodality treatment of lung metastases 23,24 ; this seems to be particularly effective in terms of local RFS when target nodules have a diameter smaller than 3 cm. 24…”

Section: Discussionmentioning

confidence: 99%

Outcome of patients with colorectal cancer undergoing lung metastases resection: a single-institution retrospective analysis

Mammana

Bergamo

Procaccio

et al. 2020

Tumori

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Introduction: This study was undertaken to review a single-institution cohort of patients with metastatic colorectal cancer undergoing lung resection after a multidisciplinary evaluation and to investigate the main prognostic factors for survival. Methods: Medical records of 129 patients undergoing lung metastasectomy for colorectal cancer with curative intent from 2001 to 2017 were reviewed. Tissue samples from the primary tumor were analyzed with a multiplex genotyping system for the detection of mutations in RAS and BRAF genes. Survival analyses were carried out by the Kaplan-Meier method. Univariate and multivariable analyses were performed using the log-rank test and the Cox regression model. Results: Postoperative morbidity and mortality were 13.2% and 0%, respectively. At a median follow-up time of 62.5 months, median overall survival was 90.5 months and median relapse-free survival was 42.8 months. Multivariable analysis for overall survival identified synchronous versus metachronous metastatic presentation as the only prognostic factor, whereas relapse-free survival was independently associated with synchronous versus metachronous metastatic presentation, number of metastases, and postoperative chemotherapy. Conclusions: This study shows particularly favorable survival outcomes for patients undergoing lung metastasectomy. The validity of some of the main prognostic factors was confirmed and a positive effect of postoperative chemotherapy on relapse-free survival was shown. Contrary to other reports, the presence of KRAS mutations was not associated with significant survival differences. Further studies are needed in order to clarify the interactions between molecular, clinical, and pathologic characteristics and treatment-related factors.

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Stereotactic ablative radiation therapy for pulmonary metastases: Improving overall survival and identifying subgroups at high risk of local failure

Cited by 22 publications

References 34 publications

The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

The roles of surgery, stereotactic radiation, and ablation for treatment of pulmonary metastases

Access of Patients With Lung Cancer to High Technology Radiation Therapy in Brazil

Outcome of patients with colorectal cancer undergoing lung metastases resection: a single-institution retrospective analysis

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