Systematic review of stereotactic body radiotherapy for nodal metastases

Francesco Deodato, Gabriella Macchia, Milly Buwenge, Mattia Bonetti, Savino Cilla, Alice Zamagni, Alessia Re, Donato Pezzulla, Francesco Cellini, Lidia Strigari, Vincenzo Valentini, Alessio G. Morganti

Research output: Contribution to journalReview articlepeer-review


The aim of this analysis was to assess the efficacy of stereotactic body radiotherapy (SBRT) in terms of local control (LC) and progression-free survival (PFS) in patients with lymph node metastases (NMs) from solid tumors. A systematic literature search from the earliest date to July 25th, 2019 was performed following PRISMA guidelines. Papers reporting LC and/or PFS of NMs using SBRT (< 10 fractions) were selected. The clinical outcomes rates were pooled by means of a random or fixed-effect model. Twenty-nine studies were eligible (969 patients: 938 (LC) and 698 (PFS)). LC and PFS results were reported in 28 and 18 papers, respectively. Heterogeneity was observed in terms of patient and treatment characteristics. Pooled 2-year LC reported in 11 studies was 79.3% (95%CI, 72.8%–85.7%) with substantial heterogeneity between studies (Q2 test: p = 0.0083; I2 = 57.9%), while pooled 2-year PFS reported in 8 studies was 35.9% (95%CI, 22.1%–49.7%) with very high heterogeneity between studies (Q2 test: p < 0.0001; I2 = 86.1%). Grade ≥ 3 and Grade 5 toxicity rates were 2.0% and 0.2%, respectively. SBRT of NMs seems to be safe and effective in terms of LC. However, due to the marked heterogeneity of the included series, prospective studies are required.

Original languageEnglish
Pages (from-to)11-29
Number of pages19
JournalClinical and Experimental Metastasis
Issue number1
Publication statusPublished - Feb 2021


  • Lymph nodes
  • Metastasis
  • SBRT
  • Stereotactic body radiotherapy
  • Systematic review

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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