Analyses of the local control of pulmonary Oligometastases after stereotactic body radiotherapy and the impact of local control on survival

BMC Cancer

Kuniaki Katsui¹  Takashi Shintani²  Mitsuru Kobayashi³  Masahiko Aoki⁴  Kazunari Yamada⁵  Atsushi Nishikawa⁶  Masatoki Ozaki⁷  Takaya Yamamoto⁸  Keiichi Jingu⁸  Ryoong-Jin Oh⁹  Yoshihiko Manabe^1,10  Atsuro Terahara^1,11  Yuzuru Niibe^1,12  Katsuya Yahara^1,13  Hideomi Yamashita^1,14  Hiroshi Onishi^1,15 

[1] Department of Proton Beam Therapy, Okayama University, 2-5-1 Shikata-cho, Kitaku, 700-8558, Okayama, Japan;Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, 54 Shogoinkawahara-cho, Sakyo-ku, 606-8501, Kyoto, Japan;Department of Radiation Oncology, Fukuyama City Hospital, 5-23-1 Zao-cho, 721-8511, Fukuyama, Japan;Department of Radiation Oncology, Hirosaki University, 1 Bunkyo-cho, 036-8560, Hirosaki, Japan;Department of Radiation Oncology, Seirei Mikatahara General Hospital, 3453 Mikatahara-cho, Kita-ku, 433-8558, Hamamatsu, Japan;Department of Radiation Oncology, Shikoku Cancer Center, 160 Minamiumemoto-machi, 791-0280, Matsuyama, Japan;Department of Radiation Oncology, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, 424-8636, Shizuoka, Japan;Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, 980-8574, Sendai, Japan;Department of Radiology, Miyakojima IGRT Clinic, 1-16-22 Miyakojima-hondori, Miyakojima-ku, 534-0021, Osaka, Japan;Department of Radiology, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, 467-8601, Nagoya, Japan;Department of Radiology, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, 143-8540, Tokyo, Japan;Department of Radiology, Toho University Omori Medical Center, 6-11-1 Omorinishi, Ota-ku, 143-8540, Tokyo, Japan;Department of Public Health, Kurume University School of Medicine, 67 Asahi-machi, 830-0011, Kurume, Japan;Department of Radiology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, 807-8555, Kitakyushu, Japan;Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, 113-8655, Tokyo, Japan;Department of Radiology, Yamanashi University, 1110 Shimokato, 409-3898, Chuo, Japan;

关键词: Pulmonary oligometastases;    Oligo-recurrence;    Sync-oligometastases;    Stereotactic body radiotherapy;    Local control;    Metastasis-directed therapy;   

DOI  :  10.1186/s12885-020-07514-9

来源: Springer

【 摘 要 】

BackgroundSuccessful local therapy for oligometastases may lead to longer survival. The purpose of this multicentre retrospective study was to investigate factors affecting the local control (LC) of pulmonary oligometastases treated by stereotactic body radiotherapy (SBRT) and to investigate the impact of LC on survival.MethodsThe inclusion criteria included 1 to 5 metastases, the primary lesion and other extrathoracic metastases were controlled before SBRT, and the biological effective dose (BED10) of the SBRT was 75 Gy or more. The Cox proportional hazards model was used for analyses.ResultsData of 1378 patients with 1547 tumours from 68 institutions were analysed. The median follow-up period was 24.2 months. The one-year, 3-year and 5-year LC rates were 92.1, 81.3 and 78.6%, respectively, and the 1-year, 3-year and 5-year overall survival rates were 90.1, 60.3 and 45.5%, respectively. Multivariate analysis for LC showed that increased maximum tumour diameter (p = 0.011), type A dose calculation algorithm (p = 0.005), shorter overall treatment time of SBRT (p = 0.035) and colorectal primary origin (p < 0.001 excluding oesophagus origin) were significantly associated with a lower LC rate. In the survival analysis, local failure (p < 0.001), worse performance status (1 vs. 0, p = 0.013; 2–3 vs. 0, p < 0.001), oesophageal primary origin (vs. colorectal origin, p = 0.038), squamous cell carcinoma (vs. adenocarcinoma, p = 0.006) and increased maximum tumour diameter (p < 0.001) showed significant relationships with shorter survival.ConclusionsSeveral factors of oligometastases and SBRT affected LC. LC of pulmonary oligometastases by SBRT showed a significant survival benefit compared to patients with local failure.

【 授权许可】

CC BY