The role of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in the elderly

Marta Scorsetti, Elena Clerici, Piera Navarria, Giuseppe D'Agostino, Lorenzo Piergallini, Fiorenza De Rose, Annamaria Ascolese, Angelo Tozzi, Cristina Iftode, Elisa Villa, Tiziana Comito, Ciro Franzese, Pietro Mancosu, Stefano Tomatis, Luca Cozzi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To report about clinical outcome of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in elderly patients. Methods: Patients with 1-4 inoperable metastases were treated with SBRT. Dose prescription ranged from 40 to 75Gy in 3-8 fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and disease-specific survival (DSS). Results: 82 patients with 111 total metastases were treated. Median age was 79 years. 64 patients (78%) had a single lesion; the remaining patients had 2-4 lesions. 16 (14.4%) lesions were localized in the abdomen, 50 (45.0%) in the liver and 45 (40.5%) in the lungs. Local response was observed for 87 lesions (78.4%) while local progression was observed in 24 lesions (21.6%). Actuarial 1-year LC was 86.8%63.3%. Actuarial 1-year OS was 93.6%62.7%. 2-year findings were 76.3%64.4% and 72.0%65.6%, respectively. Actuarial 1- and 2-year DSS results were 97.5%62.0% and 81.6%64.9%, respectively. Treatment-related Grade 2-3 toxicity was observed in five patients (4.2%); Grade 1 toxicity in seven patients (5.9%) and no toxicity was observed in 85.4% of the cases. Conclusion: SBRT is a safe and effective therapeutic option for the treatment of oligometastatic disease in the elderly with acceptable rates of LC and low treatmentrelated toxicity. Advances in knowledge: The use of SBRT for oligometastatic disease in the elderly can be considered as a valuable approach, particularly for patients with fragile status or refusing other approaches.

Original languageEnglish
Article number20150111
JournalBritish Journal of Radiology
Volume88
Issue number1053
DOIs
Publication statusPublished - Sep 1 2015

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

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