Surgery Versus Stereotactic Radiotherapy for Treatment of Pulmonary metastases. a Systematic Review of Literature

Londero, Francesco; Grossi, William; Morelli, Angelo; Parise, Orlando; Masullo, Gianluca; Tetta, Cecilia; Livi, Ugolino; Gelsomino, Sandro

doi:10.2144/fsoa-2019-0120

Cited by 35 publications

(31 citation statements)

References 94 publications

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“…1,2 While pulmonary metastasectomy is the standard treatment for patients with a limited metastatic pattern, several retrospective studies have shown that x-ray stereotactic body radiation therapy (SBRT) yields short-term promising outcomes that are comparable to those of surgery. 3,4 Proton beam therapy (PBT) can reduce the volume of and radiation dose to the surrounding normal tissues using the sharp Bragg peak fall-off, as demonstrated in previous dosimetry studies. 5,6 Based on increasing evidence for the use of PBT for early-stage lung tumors, which show acceptable outcomes with the potential benefit of reducing toxicities, PBT seems to yield outcomes similar to those of x-ray SBRT for pulmonary oligometastases.…”

Section: Introductionmentioning

confidence: 98%

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Multi-Institutional Retrospective Analysis of the Outcomes of Proton Beam Therapy for Patients With 1 to 3 Pulmonary Oligometastases From Various Primary Cancers

Aibe

Ogino

Teramukai

et al. 2021

Advances in Radiation Oncology

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Section: Introductionmentioning

confidence: 98%

“… 1 , 2 Although pulmonary metastasectomy is the standard treatment for patients with a limited metastatic pattern, several retrospective studies have shown that x-ray stereotactic body radiation therapy (SBRT) yields short-term promising outcomes that are comparable to those of surgery. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

Multi-Institutional Retrospective Analysis of the Outcomes of Proton Beam Therapy for Patients With 1 to 3 Pulmonary Oligometastases From Various Primary Cancers

Aibe

Ogino

Teramukai

et al. 2021

Advances in Radiation Oncology

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“…Local control rates were excellent at 100% and 96% at 1-and 2-year follow-up respectively (20). Similar high local control rates in the order of magnitude of 90% at 1 year and 80% at 2 years have been reported in retrospective studies, again including a multitude of primary tumors (39,(62)(63)(64). De Rose et al reported on 60 NSCLC patients with 90 lung metastases treated with SBRT (64).…”

Section: Outcome Per Location: An Intricate Interplay Of Dose Volume and Primary Tumormentioning

confidence: 61%

“…This difference in outcome seems to especially hold for lesions larger than 2 cm (72). In retrospective studies, surgery tends to either have similar or better outcomes than radiotherapy (62,66,73). Yet, when comparing different treatment modalities using retrospective data, the results are inherently biased.…”

Section: Outcome Per Location: An Intricate Interplay Of Dose Volume and Primary Tumormentioning

confidence: 99%

Radiotherapy for oligometastatic non-small cell lung cancer: a narrative review

Sundahl

Lievens

2021

Transl Lung Cancer Res

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Preclinical and early clinical evidence suggest that radical radiotherapy of oligometastatic disease in non-small cell lung cancer (NSCLC) patients can impact outcomes with relatively limited toxicity. Whilst data from phase 2 randomized trials suggesting an improved overall survival (OS) with this treatment is promising, it has also illustrated the heterogeneity in this patient population and treatment.Oligometastatic disease in itself comprises a broad spectrum of patients, in terms of tumor load and location, stage of the disease and treatment history. This real-life variety in patient characteristics is often reflected in studies to a certain extent, hinting to the fact that all might benefit from radical radiotherapy to limited metastatic disease, yet leaving the question unanswered as to whom the ideal candidate is. Furthermore, differences between and within studies with regards to treatment modality, timing, radiation technique, and radiation dose are substantial. Also, preclinical and early clinical trials suggest that radiotherapy can work synergistically with checkpoint inhibitors by acting as an in situ cancer vaccine, therefore the combination of these two treatments in oligometastatic patients might entail the largest benefit. Ongoing randomized controlled phase 3 trials and prospective registry trials will further elucidate the true extent of benefit of this local treatment strategy and aid in identifying the ideal patient population and therapy. The current narrative review summarizes the clinical evidence on radiotherapy for oligometastatic NSCLC and highlights the remaining unknowns.

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“…Therefore, a detailed histological clarification should be pursued to plan further therapeutic measures and to predict survival. Recently, LONDERO et al [52] reviewed and compared the outcome following SBRT and surgery for the treatment of pulmonary metastases. 61 articles on surgery and 18 on SBRT were found to be eligible, each with cohorts of >50 patients.…”

Section: Lung Oligometastasesmentioning

confidence: 99%

How to handle oligometastatic disease in nonsmall cell lung cancer

Eichhorn

Winter

2021

Eur Respir Rev

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Patients with nonsmall cell lung cancer and limited metastatic disease have been defined as oligometastatic if local ablative therapy of all lesions is amenable. Evidence from different clinical retrospective series suggests that this subgroup harbours better prognosis than other stage IV patients. However, most reports have included patients with inconsistent numbers of metastases in different locations treated by a variety of invasive and noninvasive therapies. As long as further results from randomised clinical trials are awaited, treatment decision follows an interdisciplinary debate in each individual case. Surgery and radiotherapy should capture a dominant role in the treatment course offering the option of a curative-intended local therapy in combination with a systemic therapy based on an interdisciplinary decision. This review summarises the current treatment standard in oligometastatic lung cancer with focus on an ablative therapy for both lung primary and distant metastases in prognostically favourable locations.

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Surgery Versus Stereotactic Radiotherapy for Treatment of Pulmonary metastases. a Systematic Review of Literature

Cited by 35 publications

References 94 publications

Multi-Institutional Retrospective Analysis of the Outcomes of Proton Beam Therapy for Patients With 1 to 3 Pulmonary Oligometastases From Various Primary Cancers

Multi-Institutional Retrospective Analysis of the Outcomes of Proton Beam Therapy for Patients With 1 to 3 Pulmonary Oligometastases From Various Primary Cancers

Radiotherapy for oligometastatic non-small cell lung cancer: a narrative review

How to handle oligometastatic disease in nonsmall cell lung cancer

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