Additional chemotherapy improved local control and overall survival after stereotactic body radiation therapy for patients with oligo-recurrence

Radiation Oncology

Hiroki Kawaguchi¹  Hideki Nishimura¹  Hiroshi Mayahara¹  Aya Harada¹  Naoki Hashimoto¹  Masaki Nakamura¹  Haruka Uezono²  Yoshiro Matsuo³  Ryo Nishikawa⁴ 

[1] Department of Radiation Oncology, Kobe Minimally invasive Cancer Center;Department of Radiation Oncology, University of Florida Proton Therapy Institute;Department of Radiology, Hyogo Ion Beam Medical Center;Division of Radiation Oncology, Kobe University Graduate School of Medicine;

关键词: Oligo;    Meta;    Recurrence;    SBRT;    Lung;    Liver;   

DOI  :  10.1186/s13014-018-1031-0

来源: DOAJ

【 摘 要 】

Abstract Background Oligo-recurrence has been considered to confer improved prognosis than other oligometastatic conditions, and stereotactic body radiation therapy (SBRT) is considered as an option of local therapy for lung or liver metastases. The purpose of this study was to investigate the efficacy and safety of SBRT for lung and liver oligo-recurrent lesions and evaluate predictive factors for local control and prognosis. Methods This retrospective study included patients who presented with 1–3 matachronous lung or liver metastases, and treated with SBRT between May 2013 and March 2016 at a single institution. All patients harbored a controlled primary lesion. Patients with < 6 months of follow-up were excluded. Local control, progression free survival, and overall survival rates were analyzed according to the Kaplan–Meier product limit method. Univariable log-rank and multivariable Cox regression analyses were performed to clarify predictive factors for local control and prognosis. Toxicity was graded according to the Common Terminology Criteria for Adverse Events, version 4.0. Results Seventy-six patients with a total of 70 and 44 lung and liver lesions were included. The median follow-up period was 21 (range, 7–43) months. The 1-year local control, progression-free survival and overall survival rates were 89, 38 and 96%, respectively. Smaller gross tumor volume and additional chemotherapy after SBRT were significant predictive factors for better local control (p = 0.005 and p = 0.047), and the presence of a single metastatic lesion was a significant factor of good progression free survival (p = 0.008). Additional chemotherapy after SBRT was not a significant predictive factor but conferred to better overall survival (p = 0.078). Among colorectal cancer patients, post SBRT chemotherapy was significantly associated with better OS (p = 0.025). Over grade 3 adverse event was seen in only one patient. Conclusion SBRT is a safe and effective treatment for patients with lung and liver oligo-recurrence. Additional chemotherapy after SBRT improved local control, and single metastatic lesion was a significant predictive factor of better PFS in this study. Among colorectal cancer patients, additional chemotherapy after SBRT significantly associated better OS.

【 授权许可】

Unknown