Hypofractionated stereotactic radiotherapy for oligometastatic patients: developing of a response predictive model

Barbara Diletto, Nicola Dinapoli, Silvia Chiesa, Gian Carlo Mattiucci, Vincenzo Frascino, Carmelo Anile, Cesare Colosimo, Vincenzo Valentini, Mario Balducci

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: Treatment of oligometastatic patients is a current challenge in radiation oncology. Aim of this study is to define a dose-response relationship for hypofractionated radiotherapy of oligometastases.

METHODS: Retrospective analysis of metastases treated by hypofractionated stereotactic radiotherapy was performed. Delivered dose was calculated both as biological effective dose (BED10), and as ratio between BED10 and the logarithm of metastasis volume (BED10 logVolume Ratio, BVR). Two dose-response models were defined by logistic regression. The fitted outcome was the Metastases Complete Response (MCR). Performances of the models were assessed by area under the receiver operating curve (AUC) and by bootstrap calibration of original data. BED10 and BVR impact on survival outcomes has been evaluated.

RESULTS: Fifty-three patients with 79 metastases were analyzed. AUC and calibration of BVR-based logistic model showed better accuracy in predicting MCR with respect to BED10-based model. No significant difference between the two ROCs was observed (De Long test p value > 0.05), but significant discordance in calibration resulted in the BED10 model (p value < 0.05 in Hosmer-Lemeshow Goodness of fit test). BVR returned also better results in multivariate analyses for survival outcomes.

CONCLUSIONS: The ratio between BED10 and the logarithm of metastasis volume (BVR), as a corrective factor for fitting the probability of metastases response to stereotactic radiotherapy, could be a tool for evaluating and prescribing treatments for oligometastatic disease. BVR can be useful for producing more reliable survival statistics too.

Original languageEnglish
Pages (from-to)146
JournalMedical oncology (Northwood, London, England)
Volume35
Issue number11
DOIs
Publication statusPublished - Sep 14 2018

Fingerprint

Radiotherapy
Neoplasm Metastasis
Calibration
Area Under Curve
Survival
Logistic Models
Radiation Oncology
Multivariate Analysis
Therapeutics

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Models, Theoretical
  • Neoplasms/diagnosis
  • Predictive Value of Tests
  • Radiation Dose Hypofractionation
  • Radiosurgery/methods
  • Radiotherapy Dosage
  • Retrospective Studies
  • Treatment Outcome

Cite this

Hypofractionated stereotactic radiotherapy for oligometastatic patients : developing of a response predictive model. / Diletto, Barbara; Dinapoli, Nicola; Chiesa, Silvia; Mattiucci, Gian Carlo; Frascino, Vincenzo; Anile, Carmelo; Colosimo, Cesare; Valentini, Vincenzo; Balducci, Mario.

In: Medical oncology (Northwood, London, England), Vol. 35, No. 11, 14.09.2018, p. 146.

Research output: Contribution to journalArticle

@article{6a87891dad024411adad878d182c01fa,
title = "Hypofractionated stereotactic radiotherapy for oligometastatic patients: developing of a response predictive model",
abstract = "OBJECTIVES: Treatment of oligometastatic patients is a current challenge in radiation oncology. Aim of this study is to define a dose-response relationship for hypofractionated radiotherapy of oligometastases.METHODS: Retrospective analysis of metastases treated by hypofractionated stereotactic radiotherapy was performed. Delivered dose was calculated both as biological effective dose (BED10), and as ratio between BED10 and the logarithm of metastasis volume (BED10 logVolume Ratio, BVR). Two dose-response models were defined by logistic regression. The fitted outcome was the Metastases Complete Response (MCR). Performances of the models were assessed by area under the receiver operating curve (AUC) and by bootstrap calibration of original data. BED10 and BVR impact on survival outcomes has been evaluated.RESULTS: Fifty-three patients with 79 metastases were analyzed. AUC and calibration of BVR-based logistic model showed better accuracy in predicting MCR with respect to BED10-based model. No significant difference between the two ROCs was observed (De Long test p value > 0.05), but significant discordance in calibration resulted in the BED10 model (p value < 0.05 in Hosmer-Lemeshow Goodness of fit test). BVR returned also better results in multivariate analyses for survival outcomes.CONCLUSIONS: The ratio between BED10 and the logarithm of metastasis volume (BVR), as a corrective factor for fitting the probability of metastases response to stereotactic radiotherapy, could be a tool for evaluating and prescribing treatments for oligometastatic disease. BVR can be useful for producing more reliable survival statistics too.",
keywords = "Adult, Aged, Aged, 80 and over, Female, Follow-Up Studies, Humans, Male, Middle Aged, Models, Theoretical, Neoplasms/diagnosis, Predictive Value of Tests, Radiation Dose Hypofractionation, Radiosurgery/methods, Radiotherapy Dosage, Retrospective Studies, Treatment Outcome",
author = "Barbara Diletto and Nicola Dinapoli and Silvia Chiesa and Mattiucci, {Gian Carlo} and Vincenzo Frascino and Carmelo Anile and Cesare Colosimo and Vincenzo Valentini and Mario Balducci",
year = "2018",
month = "9",
day = "14",
doi = "10.1007/s12032-018-1206-4",
language = "English",
volume = "35",
pages = "146",
journal = "Medical Oncology",
issn = "1357-0560",
publisher = "Humana Press Inc.",
number = "11",

}

TY - JOUR

T1 - Hypofractionated stereotactic radiotherapy for oligometastatic patients

T2 - developing of a response predictive model

AU - Diletto, Barbara

AU - Dinapoli, Nicola

AU - Chiesa, Silvia

AU - Mattiucci, Gian Carlo

AU - Frascino, Vincenzo

AU - Anile, Carmelo

AU - Colosimo, Cesare

AU - Valentini, Vincenzo

AU - Balducci, Mario

PY - 2018/9/14

Y1 - 2018/9/14

N2 - OBJECTIVES: Treatment of oligometastatic patients is a current challenge in radiation oncology. Aim of this study is to define a dose-response relationship for hypofractionated radiotherapy of oligometastases.METHODS: Retrospective analysis of metastases treated by hypofractionated stereotactic radiotherapy was performed. Delivered dose was calculated both as biological effective dose (BED10), and as ratio between BED10 and the logarithm of metastasis volume (BED10 logVolume Ratio, BVR). Two dose-response models were defined by logistic regression. The fitted outcome was the Metastases Complete Response (MCR). Performances of the models were assessed by area under the receiver operating curve (AUC) and by bootstrap calibration of original data. BED10 and BVR impact on survival outcomes has been evaluated.RESULTS: Fifty-three patients with 79 metastases were analyzed. AUC and calibration of BVR-based logistic model showed better accuracy in predicting MCR with respect to BED10-based model. No significant difference between the two ROCs was observed (De Long test p value > 0.05), but significant discordance in calibration resulted in the BED10 model (p value < 0.05 in Hosmer-Lemeshow Goodness of fit test). BVR returned also better results in multivariate analyses for survival outcomes.CONCLUSIONS: The ratio between BED10 and the logarithm of metastasis volume (BVR), as a corrective factor for fitting the probability of metastases response to stereotactic radiotherapy, could be a tool for evaluating and prescribing treatments for oligometastatic disease. BVR can be useful for producing more reliable survival statistics too.

AB - OBJECTIVES: Treatment of oligometastatic patients is a current challenge in radiation oncology. Aim of this study is to define a dose-response relationship for hypofractionated radiotherapy of oligometastases.METHODS: Retrospective analysis of metastases treated by hypofractionated stereotactic radiotherapy was performed. Delivered dose was calculated both as biological effective dose (BED10), and as ratio between BED10 and the logarithm of metastasis volume (BED10 logVolume Ratio, BVR). Two dose-response models were defined by logistic regression. The fitted outcome was the Metastases Complete Response (MCR). Performances of the models were assessed by area under the receiver operating curve (AUC) and by bootstrap calibration of original data. BED10 and BVR impact on survival outcomes has been evaluated.RESULTS: Fifty-three patients with 79 metastases were analyzed. AUC and calibration of BVR-based logistic model showed better accuracy in predicting MCR with respect to BED10-based model. No significant difference between the two ROCs was observed (De Long test p value > 0.05), but significant discordance in calibration resulted in the BED10 model (p value < 0.05 in Hosmer-Lemeshow Goodness of fit test). BVR returned also better results in multivariate analyses for survival outcomes.CONCLUSIONS: The ratio between BED10 and the logarithm of metastasis volume (BVR), as a corrective factor for fitting the probability of metastases response to stereotactic radiotherapy, could be a tool for evaluating and prescribing treatments for oligometastatic disease. BVR can be useful for producing more reliable survival statistics too.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Male

KW - Middle Aged

KW - Models, Theoretical

KW - Neoplasms/diagnosis

KW - Predictive Value of Tests

KW - Radiation Dose Hypofractionation

KW - Radiosurgery/methods

KW - Radiotherapy Dosage

KW - Retrospective Studies

KW - Treatment Outcome

U2 - 10.1007/s12032-018-1206-4

DO - 10.1007/s12032-018-1206-4

M3 - Article

C2 - 30218407

VL - 35

SP - 146

JO - Medical Oncology

JF - Medical Oncology

SN - 1357-0560

IS - 11

ER -