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@article{1497637,
author = {Burkoň, Petr and Kazda, Tomáš and Pospíšil, Petr and Slávik, Marek and Komínek, Libor and Selingerová, Iveta and Blakaj, D. M. and Procházka, Tomáš and Vrzal, Miroslav and Řehák, Zdeněk and Šlampa, Pavel},
article_location = {Bratislava},
article_number = {2},
doi = {http://dx.doi.org/10.4149/neo_2018_180731N558},
keywords = {oligometastatic disease; stereotactic body radiotherapy; ablative radiotherapy; liver metastases; lung metastases},
language = {eng},
issn = {0028-2685},
journal = {Neoplasma},
title = {Ablative dose stereotactic body radiation therapy for oligometastatic disease: a prospective single institution study},
url = {http://dx.doi.org/10.4149/neo_2018_180731N558},
volume = {66},
year = {2019}
}
TY - JOUR
ID - 1497637
AU - Burkoň, Petr - Kazda, Tomáš - Pospíšil, Petr - Slávik, Marek - Komínek, Libor - Selingerová, Iveta - Blakaj, D. M. - Procházka, Tomáš - Vrzal, Miroslav - Řehák, Zdeněk - Šlampa, Pavel
PY - 2019
TI - Ablative dose stereotactic body radiation therapy for oligometastatic disease: a prospective single institution study
JF - Neoplasma
VL - 66
IS - 2
SP - 315-325
EP - 315-325
PB - Slovenská akademie vied
SN - 00282685
KW - oligometastatic disease
KW - stereotactic body radiotherapy
KW - ablative radiotherapy
KW - liver metastases
KW - lung metastases
UR - http://dx.doi.org/10.4149/neo_2018_180731N558
L2 - http://dx.doi.org/10.4149/neo_2018_180731N558
N2 - Localized, metastasis-directed stereotactic body radiation therapy (SBRT) of oligometastatic disease (OD) is currently rapidly evolving standard of care in many institutions. Further reports of outcomes are required to strengthen the level of evidence in the absence of comparative trials evaluating different practical procedures. The aim of this prospective single institutional study is to analyse, in unselected cohort of patients from real-world clinical practice, the long-term survival, tumor control outcomes and safety of SBRT in OD (radical ablative radiotherapy with biological equivalent dose BED10>100 Gy). In addition to standard toxicity and survival parameters, we report unique outcomes as FFWD - Freedom from widespread dissemination, FFNT - Freedom from the need of subsequent treatment and functional survival with Karnofsky performance status higher than 70%. A total of 110 patients were prospectively evaluated, 60% and 40% were treated for lung and liver oligometastatic disease, respectively. No grade 3 or 4 acute toxicities (CTCAE) were reported. With median follow up of 22.2 months and 2-year overall survival of 88.3%, four patients (6.1%) experienced local progression in the lung SBRT cohort. In the liver SBRT cohort, median follow up was 33 months, 2-year overall survival was 68.5% and 11 patients (25%) experienced local and 36 (81.8%) distal progression. Higher BED10 of 150-170 Gy compared to 100-150 Gy was an independent positive prognostic factor for local progression-free survival for all patients with hazard ratio 0.25.1 his confirms SBRT ablative radiobiology effects to be independent of OD primary histology and location. The best outcomes in terms of FFNT were observed in the multivariable analysis of patients with 1-2 lung OD compared to both the liver OD cohort and patients with more than 2 lung metastases. Better FFNT in the liver SBRT cohort was observed in patients with 1-2 liver metastases and in patients whose liver OD was irradiated by higher BED10. In conclusion, SBRT is a suitable option for patients who are not surgical candidates; with approximately 30% of patients not requiring subsequent treatment 2 years after SBRT. We believe that this treatment represents a safe and effective option for oligometastatic involvement in patients with various primary tumors.
ER -
BURKOŇ, Petr, Tomáš KAZDA, Petr POSPÍŠIL, Marek SLÁVIK, Libor KOMÍNEK, Iveta SELINGEROVÁ, D. M. BLAKAJ, Tomáš PROCHÁZKA, Miroslav VRZAL, Zdeněk ŘEHÁK and Pavel ŠLAMPA. Ablative dose stereotactic body radiation therapy for oligometastatic disease: a prospective single institution study. \textit{Neoplasma}. Bratislava: Slovenská akademie vied, 2019, vol.~66, No~2, p.~315-325. ISSN~0028-2685. Available from: https://dx.doi.org/10.4149/neo\_{}2018\_{}180731N558.
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