Stereotactic ablative body radiotherapy (SABR) in pulmonary oligometastatic/oligorecurrent non-small cell lung cancer patients: A new therapeutic approach

Linda Agolli, Maurizio Valeriani, Luca Nicosia, Stefano Bracci, Vitaliana De Sanctis, Giuseppe Minniti, Riccardo Maurizi Enrici, Mattia Falchetto Osti

Research output: Contribution to journalArticle

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Abstract

Aim: Stage IV non-small cell lung cancer (NSCLC) is characterized by poor prognosis. Palliative chemotherapy and/or best supportive care are considered standard treatment. Nevertheless, for patients with limited distant metastases (1-5 metastases), called oligometastatic disease, better prognosis has been observed. We evaluated response rate, survival, time to progression and toxicity in oligometastatic/oligorecurrent NSCLC patients treated with stereotactic body radiotherapy (SBRT) delivered to all active sites in the lung. Patients and Methods: Twenty-nine lung metastases in 22 patients affected by oligometastatic/oligorecurrent NSCLC were treated with SBRT to all active sites of disease. Inclusion criteria were: controlled primary tumor with complete response or stable disease after surgery/radiotherapy/combined therapy; 4 synchronous or metachronous lung metastases at the time of treatment; no other active sites of distant metastases. Results: Response to treatment was as follows: complete response in 21% of lesions, partial response in 69% of metastases, stable disease in 10%. Ninenty-one percent of patients had complete metabolic response, and 9% had a partial metabolic response. Median follow-up was 18 months. The 1-year and 2-year OS was 86% and 49%, respectively. The 1-year and 2-year PFS was 79% and 40%, respectively. Median time to progression and median OS were 18 months and 24 months, respectively. Local control was 93% at 1 year and 64% at 2 years. Overall, acute toxicity occurred in 18% (4/22) of patients; two patients experienced grade 2 pneumonitis. Grade 2 late toxicity occurred in 50% of patients. No grade 3 toxicities were recorded. Conclusion: Aggressive stereotactic radiotherapy is a feasible and well-tolerated treatment for oligometastatic/oligorrecurrent NSCLC patients with lung metastases offering longer survival. Ablative radio therapy has a potential role in the management of well-selected stage IV NSCLC patients while increasing their quality of life and survival.

Original languageEnglish
Pages (from-to)6239-6245
Number of pages7
JournalAnticancer Research
Volume35
Issue number11
Publication statusPublished - Nov 1 2015

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Radiosurgery
Non-Small Cell Lung Carcinoma
Lung
Neoplasm Metastasis
Therapeutics
Catalytic Domain
Radiotherapy
Survival
Standard of Care
Radio
Pneumonia
Survival Rate
Quality of Life
Drug Therapy

Keywords

  • Lung metastases
  • Oligometastatic nonsmall lung cancer
  • Stereotactic body radiotherapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Agolli, L., Valeriani, M., Nicosia, L., Bracci, S., De Sanctis, V., Minniti, G., ... Osti, M. F. (2015). Stereotactic ablative body radiotherapy (SABR) in pulmonary oligometastatic/oligorecurrent non-small cell lung cancer patients: A new therapeutic approach. Anticancer Research, 35(11), 6239-6245.

Stereotactic ablative body radiotherapy (SABR) in pulmonary oligometastatic/oligorecurrent non-small cell lung cancer patients : A new therapeutic approach. / Agolli, Linda; Valeriani, Maurizio; Nicosia, Luca; Bracci, Stefano; De Sanctis, Vitaliana; Minniti, Giuseppe; Enrici, Riccardo Maurizi; Osti, Mattia Falchetto.

In: Anticancer Research, Vol. 35, No. 11, 01.11.2015, p. 6239-6245.

Research output: Contribution to journalArticle

Agolli, L, Valeriani, M, Nicosia, L, Bracci, S, De Sanctis, V, Minniti, G, Enrici, RM & Osti, MF 2015, 'Stereotactic ablative body radiotherapy (SABR) in pulmonary oligometastatic/oligorecurrent non-small cell lung cancer patients: A new therapeutic approach', Anticancer Research, vol. 35, no. 11, pp. 6239-6245.
Agolli, Linda ; Valeriani, Maurizio ; Nicosia, Luca ; Bracci, Stefano ; De Sanctis, Vitaliana ; Minniti, Giuseppe ; Enrici, Riccardo Maurizi ; Osti, Mattia Falchetto. / Stereotactic ablative body radiotherapy (SABR) in pulmonary oligometastatic/oligorecurrent non-small cell lung cancer patients : A new therapeutic approach. In: Anticancer Research. 2015 ; Vol. 35, No. 11. pp. 6239-6245.
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abstract = "Aim: Stage IV non-small cell lung cancer (NSCLC) is characterized by poor prognosis. Palliative chemotherapy and/or best supportive care are considered standard treatment. Nevertheless, for patients with limited distant metastases (1-5 metastases), called oligometastatic disease, better prognosis has been observed. We evaluated response rate, survival, time to progression and toxicity in oligometastatic/oligorecurrent NSCLC patients treated with stereotactic body radiotherapy (SBRT) delivered to all active sites in the lung. Patients and Methods: Twenty-nine lung metastases in 22 patients affected by oligometastatic/oligorecurrent NSCLC were treated with SBRT to all active sites of disease. Inclusion criteria were: controlled primary tumor with complete response or stable disease after surgery/radiotherapy/combined therapy; 4 synchronous or metachronous lung metastases at the time of treatment; no other active sites of distant metastases. Results: Response to treatment was as follows: complete response in 21{\%} of lesions, partial response in 69{\%} of metastases, stable disease in 10{\%}. Ninenty-one percent of patients had complete metabolic response, and 9{\%} had a partial metabolic response. Median follow-up was 18 months. The 1-year and 2-year OS was 86{\%} and 49{\%}, respectively. The 1-year and 2-year PFS was 79{\%} and 40{\%}, respectively. Median time to progression and median OS were 18 months and 24 months, respectively. Local control was 93{\%} at 1 year and 64{\%} at 2 years. Overall, acute toxicity occurred in 18{\%} (4/22) of patients; two patients experienced grade 2 pneumonitis. Grade 2 late toxicity occurred in 50{\%} of patients. No grade 3 toxicities were recorded. Conclusion: Aggressive stereotactic radiotherapy is a feasible and well-tolerated treatment for oligometastatic/oligorrecurrent NSCLC patients with lung metastases offering longer survival. Ablative radio therapy has a potential role in the management of well-selected stage IV NSCLC patients while increasing their quality of life and survival.",
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AU - Valeriani, Maurizio

AU - Nicosia, Luca

AU - Bracci, Stefano

AU - De Sanctis, Vitaliana

AU - Minniti, Giuseppe

AU - Enrici, Riccardo Maurizi

AU - Osti, Mattia Falchetto

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N2 - Aim: Stage IV non-small cell lung cancer (NSCLC) is characterized by poor prognosis. Palliative chemotherapy and/or best supportive care are considered standard treatment. Nevertheless, for patients with limited distant metastases (1-5 metastases), called oligometastatic disease, better prognosis has been observed. We evaluated response rate, survival, time to progression and toxicity in oligometastatic/oligorecurrent NSCLC patients treated with stereotactic body radiotherapy (SBRT) delivered to all active sites in the lung. Patients and Methods: Twenty-nine lung metastases in 22 patients affected by oligometastatic/oligorecurrent NSCLC were treated with SBRT to all active sites of disease. Inclusion criteria were: controlled primary tumor with complete response or stable disease after surgery/radiotherapy/combined therapy; 4 synchronous or metachronous lung metastases at the time of treatment; no other active sites of distant metastases. Results: Response to treatment was as follows: complete response in 21% of lesions, partial response in 69% of metastases, stable disease in 10%. Ninenty-one percent of patients had complete metabolic response, and 9% had a partial metabolic response. Median follow-up was 18 months. The 1-year and 2-year OS was 86% and 49%, respectively. The 1-year and 2-year PFS was 79% and 40%, respectively. Median time to progression and median OS were 18 months and 24 months, respectively. Local control was 93% at 1 year and 64% at 2 years. Overall, acute toxicity occurred in 18% (4/22) of patients; two patients experienced grade 2 pneumonitis. Grade 2 late toxicity occurred in 50% of patients. No grade 3 toxicities were recorded. Conclusion: Aggressive stereotactic radiotherapy is a feasible and well-tolerated treatment for oligometastatic/oligorrecurrent NSCLC patients with lung metastases offering longer survival. Ablative radio therapy has a potential role in the management of well-selected stage IV NSCLC patients while increasing their quality of life and survival.

AB - Aim: Stage IV non-small cell lung cancer (NSCLC) is characterized by poor prognosis. Palliative chemotherapy and/or best supportive care are considered standard treatment. Nevertheless, for patients with limited distant metastases (1-5 metastases), called oligometastatic disease, better prognosis has been observed. We evaluated response rate, survival, time to progression and toxicity in oligometastatic/oligorecurrent NSCLC patients treated with stereotactic body radiotherapy (SBRT) delivered to all active sites in the lung. Patients and Methods: Twenty-nine lung metastases in 22 patients affected by oligometastatic/oligorecurrent NSCLC were treated with SBRT to all active sites of disease. Inclusion criteria were: controlled primary tumor with complete response or stable disease after surgery/radiotherapy/combined therapy; 4 synchronous or metachronous lung metastases at the time of treatment; no other active sites of distant metastases. Results: Response to treatment was as follows: complete response in 21% of lesions, partial response in 69% of metastases, stable disease in 10%. Ninenty-one percent of patients had complete metabolic response, and 9% had a partial metabolic response. Median follow-up was 18 months. The 1-year and 2-year OS was 86% and 49%, respectively. The 1-year and 2-year PFS was 79% and 40%, respectively. Median time to progression and median OS were 18 months and 24 months, respectively. Local control was 93% at 1 year and 64% at 2 years. Overall, acute toxicity occurred in 18% (4/22) of patients; two patients experienced grade 2 pneumonitis. Grade 2 late toxicity occurred in 50% of patients. No grade 3 toxicities were recorded. Conclusion: Aggressive stereotactic radiotherapy is a feasible and well-tolerated treatment for oligometastatic/oligorrecurrent NSCLC patients with lung metastases offering longer survival. Ablative radio therapy has a potential role in the management of well-selected stage IV NSCLC patients while increasing their quality of life and survival.

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KW - Oligometastatic nonsmall lung cancer

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