SBRT for lung oligometastases: Who is the perfect candidate?

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Abstract

Aim: To analyze the literature data about lung oligometastatic patients who underwent SBRT with regard to doses, fractionation, outcomes, response assessment and prognostic factors, trying to define "the right patient" for the local treatment. Background: "Oligometastatic disease" is defined as a state in which metastases are limited in number and site and characterized by unusual cancer biology and behavior. In this setting local therapy could have a potential curative role. Recently, technological advances in Radiation Oncology permitted the introduction of Stereotactic Body Radiation Therapy (SBRT), a novel treatment modality that delivers ablative dose of radiation to the extra-cranial sites with high precision using single or a small number of fractions. Materials and methods: We performed a literature search using Medical Subject Heading terms "stereotactic body radiation therapy" and "lung metastases", considering a period of 10 years. Results: Many non-randomized studies have shown that SBRT for lung oligometastases is safe and effective, with local control rates of about 80%. To date SBRT represents an alternative and competitive option in patients with lung oligometastatic disease who refuse surgical treatment or unsuitable for surgery. Based on published studies, SBRT might have major benefit for a patient with breast histology, disease-free interval ≥12 months, control of the primary tumor, small lesions, limited number of lesions and higher radiation dose delivered. Conclusions: Well-designed collaborative trials are necessary to draw final conclusions. To date, the discussion within a multidisciplinary team becomes crucial to perform a careful patients' selection in the setting of oligometastatic disease.

Original languageEnglish
Pages (from-to)446-453
Number of pages8
JournalReports of Practical Oncology and Radiotherapy
Volume20
Issue number6
DOIs
Publication statusPublished - Nov 1 2015

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Radiotherapy
Lung
Medical Subject Headings
Radiation
Dose Fractionation
Neoplasm Metastasis
Breast Diseases
Radiation Oncology
Patient Rights
Therapeutics
Patient Selection
Lung Diseases
Neoplasms
Histology
Outcome Assessment (Health Care)

Keywords

  • Lung metastases
  • Oligometastases
  • SABR
  • SBRT

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

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title = "SBRT for lung oligometastases: Who is the perfect candidate?",
abstract = "Aim: To analyze the literature data about lung oligometastatic patients who underwent SBRT with regard to doses, fractionation, outcomes, response assessment and prognostic factors, trying to define {"}the right patient{"} for the local treatment. Background: {"}Oligometastatic disease{"} is defined as a state in which metastases are limited in number and site and characterized by unusual cancer biology and behavior. In this setting local therapy could have a potential curative role. Recently, technological advances in Radiation Oncology permitted the introduction of Stereotactic Body Radiation Therapy (SBRT), a novel treatment modality that delivers ablative dose of radiation to the extra-cranial sites with high precision using single or a small number of fractions. Materials and methods: We performed a literature search using Medical Subject Heading terms {"}stereotactic body radiation therapy{"} and {"}lung metastases{"}, considering a period of 10 years. Results: Many non-randomized studies have shown that SBRT for lung oligometastases is safe and effective, with local control rates of about 80{\%}. To date SBRT represents an alternative and competitive option in patients with lung oligometastatic disease who refuse surgical treatment or unsuitable for surgery. Based on published studies, SBRT might have major benefit for a patient with breast histology, disease-free interval ≥12 months, control of the primary tumor, small lesions, limited number of lesions and higher radiation dose delivered. Conclusions: Well-designed collaborative trials are necessary to draw final conclusions. To date, the discussion within a multidisciplinary team becomes crucial to perform a careful patients' selection in the setting of oligometastatic disease.",
keywords = "Lung metastases, Oligometastases, SABR, SBRT",
author = "Pierina Navarria and {De Rose}, Fiorenza and Ascolese, {Anna Maria}",
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T2 - Who is the perfect candidate?

AU - Navarria, Pierina

AU - De Rose, Fiorenza

AU - Ascolese, Anna Maria

PY - 2015/11/1

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N2 - Aim: To analyze the literature data about lung oligometastatic patients who underwent SBRT with regard to doses, fractionation, outcomes, response assessment and prognostic factors, trying to define "the right patient" for the local treatment. Background: "Oligometastatic disease" is defined as a state in which metastases are limited in number and site and characterized by unusual cancer biology and behavior. In this setting local therapy could have a potential curative role. Recently, technological advances in Radiation Oncology permitted the introduction of Stereotactic Body Radiation Therapy (SBRT), a novel treatment modality that delivers ablative dose of radiation to the extra-cranial sites with high precision using single or a small number of fractions. Materials and methods: We performed a literature search using Medical Subject Heading terms "stereotactic body radiation therapy" and "lung metastases", considering a period of 10 years. Results: Many non-randomized studies have shown that SBRT for lung oligometastases is safe and effective, with local control rates of about 80%. To date SBRT represents an alternative and competitive option in patients with lung oligometastatic disease who refuse surgical treatment or unsuitable for surgery. Based on published studies, SBRT might have major benefit for a patient with breast histology, disease-free interval ≥12 months, control of the primary tumor, small lesions, limited number of lesions and higher radiation dose delivered. Conclusions: Well-designed collaborative trials are necessary to draw final conclusions. To date, the discussion within a multidisciplinary team becomes crucial to perform a careful patients' selection in the setting of oligometastatic disease.

AB - Aim: To analyze the literature data about lung oligometastatic patients who underwent SBRT with regard to doses, fractionation, outcomes, response assessment and prognostic factors, trying to define "the right patient" for the local treatment. Background: "Oligometastatic disease" is defined as a state in which metastases are limited in number and site and characterized by unusual cancer biology and behavior. In this setting local therapy could have a potential curative role. Recently, technological advances in Radiation Oncology permitted the introduction of Stereotactic Body Radiation Therapy (SBRT), a novel treatment modality that delivers ablative dose of radiation to the extra-cranial sites with high precision using single or a small number of fractions. Materials and methods: We performed a literature search using Medical Subject Heading terms "stereotactic body radiation therapy" and "lung metastases", considering a period of 10 years. Results: Many non-randomized studies have shown that SBRT for lung oligometastases is safe and effective, with local control rates of about 80%. To date SBRT represents an alternative and competitive option in patients with lung oligometastatic disease who refuse surgical treatment or unsuitable for surgery. Based on published studies, SBRT might have major benefit for a patient with breast histology, disease-free interval ≥12 months, control of the primary tumor, small lesions, limited number of lesions and higher radiation dose delivered. Conclusions: Well-designed collaborative trials are necessary to draw final conclusions. To date, the discussion within a multidisciplinary team becomes crucial to perform a careful patients' selection in the setting of oligometastatic disease.

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