Stereotactic Body Radiotherapy for Metachronous Multisite Oligo-Recurrence: A Long-Surviving Case with Sequential Oligo-Recurrence in Four Different Organs Treated Using Locally Radical Radiotherapy and a Review of the Literature

Abstract

Stereotactic body radiotherapy (SBRT) for oligometastases represents a recent trend in radiation oncology. While abundant data are available regarding the use of SBRT for the treatment of lung or liver oligometastases from various retrospective series and prospective trials, relatively little information has been accumulated for the treatment of oligometastases at sites other than the lungs and liver, particularly for sequential oligometastases in multiple organs. Oligometastases with primary lesions controlled is called “oligo-recurrence.” We describe herein the case of a lung cancer patient who developed repeated oligo-recurrence at multiple sites that were each controlled by radical radiotherapy and achieved long-term survival and discuss the merits of locally aggressive radiotherapy for this type of disease condition with reviewing the literature. Although further investigation should be undertaken to clarify the benefits, objectives, and methods of SBRT for the treatment of oligometastases, we believe utilization of SBRT may be worthwhile for patients with remote metastases who hope for treatment to acquire better local control and possible longer survival.

Lung stereotactic radiotherapy for oligometastases: comparison of oligo-recurrence and sync-oligometastases

“…In 61 patients treated with SBRT, local control was achieved in 89% and 2-year survival was 66.5%. Onishi et al ( 12 ) reported an excellent case report about sequential oligo-recurrence.…”

Stereotactic body radiotherapy for lung metastases as oligo-recurrence: a single institutional study

“…On the other hand, Milano et al [ 19 ] reported outcomes for patients with oligometastases who underwent two or more curative-intent stereotactic radiotherapy courses and concluded that patients treated with RT for oligometastatic disease can be offered additional courses of radiotherapy to address the interval development of limited metastases and/or locally recurrent disease. Onishi et al [ 20 ] also emphasized the importance of local aggressive radiotherapy for patients with repeated oligo-recurrence in multiple organs. In our study, ∼60% of the patients developed recurrence at a site outside the radiation field and were judged as having a second oligo-recurrence.…”

Feasibility of automated pancreas segmentation based on dynamic MRI

“…1,2 Many patients present with unresectable locally advanced lesion at the time of diagnosis. Although radiotherapy alone is unlikely to cure pancreatic cancer, with sufficiently high doses, it is possible to achieve local control or resectability conversion [3][4][5][6][7][8] that is correlated to significantly prolonged patient survival. 9 However, radiation doses to the pancreas are limited by the surrounding radiosensitive serial organs.…”