肺寡转移瘤立体定向消融放疗的长期疗效观察

doi:10.3760/cma.j.cn113030-20200628-00323

Abstract
Figure/Table
References(23)
Related Citation (15)
Read Tracking
Download Tracking

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Abstract Objective To evaluate the efficacy and safety of stereotactic ablative radiotherapy (SABR) in patients with pulmonary oligometastases. Methods Clinical data of patients with pulmonary metastases treated with SABR from 2011 to 2018 were retrospectively analyzed. The local control rate (LCR) and overall survival (OS) were calculated by Kaplan-Meier method. log-rank test was used for univariate analysis and Cox's regression model for multivariate analysis. Results A total of 214 lung metastases were detected in 159 patients, and the median follow-up time was 43 months. The 1-, 3-and 5-year LCR were 90.1%, 73.9% and 65.8%, respectively. The 1-, 3-and 5-year OS were 73.8%, 43.6% and 11.9%, respectively. Univariate analysis showed that biological effective dose (BED)≥100 Gy was significantly correlated with LCR (P=0.033). Cox's multivariate analysis showed that BED and primary tumor source were the independent prognostic factors of LCR (P=0.023, P=0.043). No>grade 3 adverse events were observed in all patients during treatment. Conclusions SABR is a safe and effective treatment of lung oligometastases. SABR should be actively aDministered for pulmonary oligometastases, especially for those with lesions from lung cancer and the radiation dose should be selected as BED ≥100 Gy.

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	Zheng Xiaoli
	Ni Peizan
	Sun Yanan
	Ye Ke
	Fan Chengcheng
	Song Shuai
	Yang Yang
	Wang Nan
	Wang Xiaohui
	Luo Hui
	Ge Hong

Key words： Neoplasm, lung oligometastases/stereotactic ablative radiotherapy Prognosis Adverse event

Received: 28 June 2020

Fund:Surface Project from National Natural Science Foundation of China (81773230)

Corresponding Authors: Ge Hong, Email:gehong666@126.com

Cite this article:

Zheng Xiaoli,Ni Peizan,Sun Yanan et al. Long-term therapeutic effect of stereotactic ablative radiotherapy for pulmonary oligometastasis[J]. Chinese Journal of Radiation Oncology, 2021, 30(4): 343-347.

URL:

http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.cn113030-20200628-00323 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2021/V30/I4/343

[1] Treasure T, Miloševiĉ M,Fiorentino F, et al. Pulmonary metastasectomy:what is the practice and where is the evidence for effectiveness?[J]. Thorax J, 2014, 69(10):946-949. DOI:10.1136/thoraxjnl-2013-204528.
[2] Hellman S, Weichselbaum RR. Oligometastases[J]. J Clin Oncol, 1995, 13(1):8-10. DOI:10.1200/jco.1995.13.1.8.
[3] Milano MT, Katz AW, Zhang H, et al. Oligometastases treated with stereotactic body radiotherapy:long-term follow-up of prospective study[J]. Int J Radiat Oncol Biol Phys, 2012, 83(3):878-886. DOI:10.1016/j.ijrobp.2011.08.036.
[4] Palma DA, Salama JK, Lo SS, et al. The oligometastatic state-separating truth from wishful thinking[J]. Nat Rev Clin Oncol, 2014, 11(9):549-557. DOI:10.1038/nrclinonc.2014.96.
[5] Kaifi JT, Gusani NJ, Deshaies I, et al. Indications and approach to surgical resection of lung metastases[J]. J Surg Oncol, 2010, 102(2):187-195. DOI:10.1002/jso.21596.
[6] Gonzalez M, Poncet A, Combescure C, et al. Risk factors for survival after lung metastasectomy in colorectal cancer patients:a systematic review and meta-analysis[J]. Ann Surg Oncol, 2013, 20(2):572-579. DOI:10.1245/s10434-012-2726-3.
[7] Pastorino U, Buyse M, Friedel G, et al. Long-term results of lung metastasectomy:prognostic analyses based on 5206 cases[J]. J Thorac Cardiovasc Surg, 1997, 113(1):37-49. DOI:10.1016/s0022-5223(97)70397-0.
[8] Abel S, Hasan S, Horne ZD, et al. Stereotactic body radiation therapy in early-stage NSCLC:historical review, contemporary evidence and future implications[J]. Lung Cancer Manag, 2019, 8(1):LMT09. DOI:10.2217/lmt-2018-0013.
[9] Rusthoven KE, Kavanagh BD, Burri SH, et al. Multi-institutional phase Ⅰ/Ⅱ trial of stereotactic body radiation therapy for lung metastases[J]. J Clin Oncol, 2009, 27(10):1579-1584. DOI:10.1200/JCO.2008.19.6386.
[10] Navarria P, Ascolese AM, Tomatis S, et al. Stereotactic body radiotherapy (SBRT) in lung oligometastatic patients:role of local treatments[J]. Radiat Oncol, 2014, 9(1):91. DOI:10.1259/bjr.20190627.
[11] Navarria P, Ascolese AM, Cozzi L, et al. Stereotactic body radiation therapy for lung metastases from soft tissue sarcoma[J]. Eur J Cancer, 2015, 51(5):668-674. DOI:10.1016/j.clon.2020.01.005.
[12] Rieber J, Streblow J, Uhlmann L, et al. Stereotactic body radiotherapy (SBRT) for medically inoperable lung metastases-a pooled analysis of the German working group “stereotactic radiotherapy”[J]. Lung Cancer, 2016, 97:51-58. DOI:10.1016/j.lungcan.2016.04.012.
[13] Palma DA, Olson R, Harrow S, et al. Stereotactic ablative radiotherapy versus standard of care palliative treatment in patients with oligometastatic cancers (SABR-COMET):a randomised, phase 2, open-label trial[J]. Lancet, 2019, 393(10185):2051-2058. DOI:10.1016/s0140-6736(18)32487-5.
[14] Timmerman RD, Hu C, Michalski JM, et al. Long-term results of stereotactic body radiation therapy in medically inoperable stage Ⅰ non-small cell lung cancer[J]. JAMA Oncol, 2018, 4(9):1287-1288. DOI:10.1001/jamaoncol.2018.1258.
[15] Bezjak A, Paulus R, Gaspar LE, et al. Safety and efficacy of a five-fraction stereotactic body radiotherapy schedule for centrally located non-small-cell lung cancer:NRG oncology/RTOG 0813 trial[J]. J Clin Oncol, 2019, 37(15):1316-1325. DOI:10.1200/jco.18.00622.
[16] Tawfik H, Rostom Y, Elghazaly H, et al. All-oral combination of vinorelbine and capecitabine as first-line treatment in HER2/Neu-negative metastatic breast cancer[J]. Cancer Chemother Pharmacol, 2013, 71(4):913-919. DOI:10.1007/s00280-013-2082-4.
[17] Van Cutsem E, Köhne CH, Láng I, et al. Cetuximab plus irinotecan, fluorouracil, and leucovorin as first-line treatment for metastatic colorectal cancer:updated analysis of overall survival according to tumor KRAS and BRAF mutation status[J]. J Clin Oncol, 2011, 29(15):2011-2019. DOI:10.1200/jco.2010.33.5091.
[18] Chudgar NP, Brennan MF, Munhoz RR, et al. Pulmonary metastasectomy with therapeutic intent for soft-tissue sarcoma[J]. J Thorac Cardiovasc Surg, 2017, 154:319-330. DOI:10.1016/j.jtcvs.2017.02.061.
[19] Franzke K, Natanov R, Zinne N, et al. Pulmonary metastasectomy-a retrospective comparison of surgical outcomes after laser-assisted and conventional resection[J]. Eur J Surg Oncol, 2017, 43(7):1357-1364. DOI:10.1016/j.ejso.2016.09.001.
[20] Widder J, Klinkenberg TJ, Ubbels JF, et al. Pulmonary oligometastases:metastasectomy or stereotactic ablative radiotherapy?[J]. Radiother Oncol, 2013, 107(3):409-413. DOI:10.1016/j.radonc.2013.05.024.
[21] NⅡBe Y, Chang JY. Novel insights of oligometastases and oligo-recurrence and review of the literature[J]. Pulm Med, 2012, 2012:261096. DOI:10.1155/2012/261096.
[22] Onishi H, Shirato H, Nagata Y, et al. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage Ⅰ non-small cell lung cancer:updated results of 257 patients in a Japanese multi-institutional study[J]. J Thorac Oncol, 2007, 2(7 suppl 3):S94-100. DOI:10.1097/JTO.0b013e318074de34.
[23] Franceschini D, Cozzi L, De Rose F, et al. Role of stereotactic body radiation therapy for lung metastases from radio-resistant primary tumours[J]. J Cancer Res Clin Oncol, 2017, 143(7):1293-1299. DOI:10.1007/s00432-017-2373-y.