J 2019

Ablative dose stereotactic body radiation therapy for oligometastatic disease: a prospective single institution study

BURKOŇ, Petr, Tomáš KAZDA, Petr POSPÍŠIL, Marek SLÁVIK, Libor KOMÍNEK et. al.

Základní údaje

Originální název

Ablative dose stereotactic body radiation therapy for oligometastatic disease: a prospective single institution study

Autoři

BURKOŇ, Petr (203 Česká republika, domácí), Tomáš KAZDA (203 Česká republika, domácí), Petr POSPÍŠIL (203 Česká republika, domácí), Marek SLÁVIK (703 Slovensko, garant, domácí), Libor KOMÍNEK (203 Česká republika), Iveta SELINGEROVÁ (203 Česká republika, domácí), D. M. BLAKAJ (840 Spojené státy), Tomáš PROCHÁZKA (203 Česká republika), Miroslav VRZAL (203 Česká republika), Zdeněk ŘEHÁK (203 Česká republika) a Pavel ŠLAMPA (203 Česká republika, domácí)

Vydání

Neoplasma, Bratislava, Slovenská akademie vied, 2019, 0028-2685

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30204 Oncology

Stát vydavatele

Slovensko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 1.721

Kód RIV

RIV/00216224:14110/19:00109147

Organizační jednotka

Lékařská fakulta

DOI

UT WoS

000465160800020

Klíčová slova anglicky

oligometastatic disease; stereotactic body radiotherapy; ablative radiotherapy; liver metastases; lung metastases

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 1. 4. 2020 21:14, Mgr. Marie Šípková, DiS.

Anotace

V originále

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.

Návaznosti

LQ1601, projekt VaV
Název: CEITEC 2020 (Akronym: CEITEC2020)
Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, CEITEC 2020