RT Journal Article
SR Electronic
T1 Stereotactic Ablative Body Radiotherapy (SABR) in Pulmonary Oligometastatic/Oligorecurrent Non-small Cell Lung Cancer Patients: A New Therapeutic Approach
JF Anticancer Research
JO Anticancer Res
FD International Institute of Anticancer Research
SP 6239
OP 6245
VO 35
IS 11
A1 LINDA AGOLLI
A1 MAURIZIO VALERIANI
A1 LUCA NICOSIA
A1 STEFANO BRACCI
A1 VITALIANA DE SANCTIS
A1 GIUSEPPE MINNITI
A1 RICCARDO MAURIZI ENRICI
A1 MATTIA FALCHETTO OSTI
YR 2015
UL http://ar.iiarjournals.org/content/35/11/6239.abstract
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.