Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer

Takeda, Atsuya; Kunieda, Etsuo; Ohashi, Toshio; Aoki, Yousuke; Koike, Naoyoshi; Takeda, Toshiaki

doi:10.1016/j.radonc.2011.05.033

Cited by 145 publications

(126 citation statements)

References 42 publications

Supporting

Mentioning

113

Contrasting

Order By: Relevance

“…In contrast, another study reported that colorectal cancer lung metastases had a significantly worse local control rate than lung metastases from other origins. 3,10 This conflicts with the earlier study that found no significant difference in outcomes between colorectal and other non-breast histology. 9 Clearly, the current data is inconsistent, perhaps, reflecting different selection criteria and relatively small subgroup analyses in the available literature at present including this study.…”

Section: Discussionmentioning

confidence: 65%

Stereotactic body radiotherapy (SBRT) in the management of extracranial oligometastatic (OM) disease

Bhattacharya¹,

Woolf²,

Hughes³

et al. 2015

BJR

View full text Add to dashboard Cite

Objective: A review of stereotactic body radiotherapy (SBRT) for oligometastases defined as three or fewer sites of isolated metastatic disease. The aim was to identify local control, overall survival (OS) and progression-free survival (PFS) of patients receiving SBRT for oligometastatic (OM) disease. Methods: Data were analysed for SBRT delivered between 01 September 2010 and 31 March 2014. End points included local control, PFS, OS and toxicity. Results: 76 patients received SBRT. The median age was 60 years (31-89 years). 44 were male. Median follow-up was 12.3 months (0.2-36.9 months). Major primary tumour sites included colorectal (38%), the breast (18%) and the prostate (12%). The treatment sites included lymph nodes (42%), the bone and spine (29%) and soft tissue (29%). 42% were previously treated with conventional radiotherapy. 45% were disease free after SBRT. 4% had local relapse, 45% had distant relapse, and 6% had local and distant relapse. Local control was 89%. The OS was 84.4% at 1 year and 63.2% at 2 years. PFS was 49.1% at 1 year and 26.2% at 2 years. Toxicities included duodenal ulcer and biliary stricture formation. Conclusion: SBRT can achieve durable control of OM lesions and results in minimal radiation-induced morbidity. Advances in knowledge: This cohort is one of the largest reported to date and contributes to the field of SBRT in oligometastases that is emerging as an important research area. It is the only study reported from the UK and uses a uniform technique throughout. The efficacy and low toxicity with durable control of local disease with this approach is shown, setting the foundations for future randomized studies.

show abstract

Section: Discussionmentioning

confidence: 65%

Stereotactic body radiotherapy (SBRT) in the management of extracranial oligometastatic (OM) disease

Bhattacharya¹,

Woolf²,

Hughes³

et al. 2015

BJR

View full text Add to dashboard Cite

show abstract

“…However, it should be noted that this observation was obtained for lung cancer; it has now become clear that colorectal AD metastases are more difficult to control than other metastases. (24,25) Therefore, the radiosensitivity of AD might differ with the primary tumor site. Another implication of the present study is that reevaluation of whether small-cell carcinoma is really more radiosensitive than SCC and AD is warranted.…”

Section: Discussionmentioning

confidence: 99%

Early response and local control of stage I non‐small‐cell lung cancer after stereotactic radiotherapy: difference by histology

et al. 2012

View full text Add to dashboard Cite

To investigate the possible influences of various factors on tumor response to radiation, regression speeds and long-term local control rates of primary adenocarcinoma and squamous cell carcinoma of the lung after stereotactic body radiotherapy were evaluated. Ninety-one patients (65 men and 26 women) with a median age of 76 years were serially examined using computed tomography at 2, 4 and 6 months after treatment. Tumor histology was adenocarcinoma in 62 patients and squamous cell carcinoma in 29 patients. The prescribed dose was 48 Gy in four fractions given twice a week for T1 tumors (≤3 cm) and 52 Gy in four fractions given twice a week for T2 tumors (3-5 cm). Tumor shrinkage speed and 3-year local control rates were similar between T1 and T2 tumors and between patients with normal pulmonary function and those with impaired function. Squamous cell carcinomas shrank faster than adenocarcinomas at 2 and 4 months after radiation, but mean relative tumor size at 6 months and local control rates at 3 years did not differ significantly between the two histologies. Tumors in patients with a higher hemoglobin level tended to shrink faster but the control rates were not different. It is concluded that, although squamous cell carcinoma shrinks faster than adenocarcinoma, the two types of lung cancer are of similar radiosensitivity in terms of longterm control rates. Radiosensitivity should not be evaluated by early tumor response. (Cancer Sci 2013; 104: 130-134) T he radiosensitivity of tumors varies with various tumorand patient-related factors. These include histology, grade of differentiation and size of tumors, and hemoglobin levels in patients. It is well known that small-cell carcinoma of the lung responds more quickly to radiation than other histological subtypes of lung cancer. In uterine cervical cancer treated with radiation, squamous cell carcinoma (SCC) is generally associated with a better prognosis than adenocarcinoma (AD); (1,2) such observations led many oncologists to assume that SCC is more radiosensitive than AD. (3,4) In addition, smaller tumors are generally more radiosensitive than larger ones.(5,6) Furthermore, extensive clinical data show that patients with a high hemoglobin level have a better prognosis than those with a low level following definitive radiotherapy of various cancers, (7)(8)(9)(10)(11) indicating that tumors in patients with a high hemoglobin level might be more radiosensitive than tumors in those with a low hemoglobin level. However, these observations mostly come from retrospective analyses of clinical data and have not been properly evaluated in a prospective study.Stereotactic body radiotherapy (SBRT) was introduced in the mid-1990s and has been performed in many institutions as a new treatment modality for stage I primary lung cancer. (12)(13)(14) Stereotactic body radiotherapy usually uses a few sessions of relatively high-dose irradiation. Therefore, if imaging studies are carried out serially after SBRT, shrinkage patterns and local control of irradiated tumors foll...

show abstract

“…Moreover, Takeda et al reported that the 2-year control rate for oligometastatic lung tumors from colorectal cancer (72%) is significantly worse than that from other origins or from primary lung cancer (94%-95%) after SBRT 8 .…”

Section: Challenges For Current Sbrt Techniquementioning

confidence: 99%

Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer

Qin

Zhang

Yoo

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose: Tumor size reduction has been observed for patients underwent lung stereotactic body radiation therapy (SBRT). Adaptive planning has the potential to reduce normal tissue toxicity and/or escalate dose to target in these patients. In this study, we evaluated the dosimetric effectiveness of adaptive planning in lung SBRT for patients who presented large target volume changes during the treatment.Methods and Materials: 20 out of 66 consecutive lung SBRT patients who showed largest percentage internal target volume (ITV) change throughout the treatment were included in the study. All patients went through 3D and 4DCT before treatment, and treatment on a Linear Accelerator machine equipped with kV imager, kV CBCT, and MV electronic portal imaging device (EPID). CBCT images were acquired at each fraction for patient positioning purpose. CBCT images for all fractions were used for contour and treatment planning. Adaptive plans were created on the CBCT images using the same planning parameters as the original CT-based plan, with the goal to achieve comparable conformality index (CI). For each patient, two cumulative plans, non-adaptive plan (PNON) and adaptive plan (PADP), were generated and compared for the following organs-at-risks (OARs): cord, esophagus, chest wall, and the lungs.Correlations were evaluated between changes in dosimetric metrics induced by adaptive planning and potential impacting factors, including tumor-to-OAR distances (dT-OAR), initial ITV (ITV1), ITV change (∆ITV), and effective ITV diameter change (∆dITV).Results: For the 20 selected patients, percentage ITV change ranged from 16.4% to 59.6%, with a mean (±SD) of 38.8% (±12.5%). CI of all plans ranged from 1.03 to 1.46, with small intra-subject variations (0.01-0.1). Compared to PNON, PADP resulted in significantly (p=0-0.02) lower values for all dosimetric metrics. ∆dITV/dT-OAR was found to correlate with changes in dose to 5cc (∆D5cc) of esophagus (r=0.77) and dose to 30cc (∆D30cc) of chest v wall (r=0.72). Stronger correlations between ∆dITV/dT-OAR and ∆D30cc of chest wall were discovered for peripheral (r=0.82) and central (r=0.94) tumors, respectively. Conclusions:Adaptive lung SBRT planning can potentially reduce dose to adjacentOARs if patients present significant tumor volume shrinkage during the treatment.

show abstract

Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer

Cited by 145 publications

References 42 publications

Stereotactic body radiotherapy (SBRT) in the management of extracranial oligometastatic (OM) disease

Stereotactic body radiotherapy (SBRT) in the management of extracranial oligometastatic (OM) disease

Early response and local control of stage I non‐small‐cell lung cancer after stereotactic radiotherapy: difference by histology

Adaptive Stereotactic Body Radiation Therapy Planning for Lung Cancer

Contact Info

Product

Resources

About