Radiosurgery and fractionated stereotactic radiotherapy in oligometastatic/oligoprogressive non-small cell lung cancer patients: Results of a multi-institutional series of 198 patients treated with “curative” intent

M. Buglione, B.A. Jereczek-Fossa, M.L. Bonù, D. Franceschini, A. Fodor, I.B. Zanetti, M.A. Gerardi, P. Borghetti, D. Tomasini, N.G. Di Muzio, O. Oneta, M. Scorsetti, C. Franzese, P. Romanelli, G. Catalano, I. Dell'Oca, G. Beltramo, G.B. Ivaldi, A. Laudati, S.M. MagriniP. Antognoni, On behalf of Italian Society of Radiotherapy and Clinical Oncology - Regional Group Lombardy (AIROL)

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (FSRT) are a therapeutic option for Oligometastatic/Oligoprogressive (OM/OP) NSCLC. This retrospective multicentre analysis aims to analyse clinical outcomes and treatment related toxicity of patients treated to all sites of know disease with SRS and/or FSRT for OM/OP NSCLC in 8 Italian radiation oncology centres. Materials and methods: From January 2016 to January 2017 198 OM/OP NSCLC patients (pts) were treated in 8 Centres. Inclusion criteria were as follows: 1–5 lesions at onset or after previous systemic treatment; Pts must have all metastatic lesions treated. Endpoints analysed were local progression free survival (LPFS); out-of-field recurrence free survival (OFPS); progression free survival (PFS); overall survival (OS). Time to New systemic Therapy free survival (TNT) and toxicity were also analysed. Results: At the time of radiotherapy, 119 pts (60 %) were treated for a single lesion, 49 (25 %) for 2 lesions, 30 (15 %) for 3–5 metastases. Total number of lesions treated was 333: 204 brain, 68 lung, 24 bone, 16 nodal, 12 adrenal, 8 liver and 1 soft tissue. 83/198 pts (41.8 %) had the primary tumour controlled at the time of the SRT. After a median follow-up of 18 months, median OS and PFS were 29.6 months and 10.6 months, respectively. One year LPFS and OPFS were 90 % and 47 %, respectively. Median TNT was 10 months. At univariate analysis factors associated with better OS were PS 0–1; controlled primary tumour, 1–2 lesions; extracranial metastasis. Multivariate analysis confirmed number of lesions
Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalLung Cancer
Volume141
DOIs
Publication statusPublished - 2020

Keywords

  • Ablative treatments
  • Non small cell lung cancer (NSCLC)
  • Oligometastasis
  • Stereotactic radiosurgery (SRS)
  • Stereotactic radiotherapy (SRT)
  • fluorodeoxyglucose f 18
  • ablation therapy
  • adrenal metastasis
  • adult
  • aged
  • Article
  • bone metastasis
  • brain metastasis
  • cancer control
  • cancer growth
  • cancer patient
  • cancer survival
  • clinical outcome
  • controlled study
  • disease burden
  • female
  • follow up
  • fractionated stereotactic radiotherapy
  • human
  • Italy
  • liver metastasis
  • lung metastasis
  • lymph node metastasis
  • major clinical study
  • male
  • metastasis
  • middle aged
  • mortality
  • multivariate analysis
  • non small cell lung cancer
  • nuclear magnetic resonance imaging
  • overall survival
  • positron emission tomography
  • priority journal
  • progression free survival
  • radiation injury
  • radiation necrosis
  • radiation oncology
  • recurrence free survival
  • retrospective study
  • soft tissue metastasis
  • stereotactic radiosurgery
  • time to new systemic therapy free survival
  • univariate analysis
  • very elderly
  • x-ray computed tomography

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