BURKOŇ, Petr, Iveta SELINGEROVÁ, Marek SLÁVIK, Petr POSPÍŠIL, Lukas BOBEK, Libor KOMINEK, Pavel OSMERA, Tomáš PROCHÁZKA, Miroslav VRZAL, Tomáš KAZDA and Pavel ŠLAMPA. Stereotactic Body Radiotherapy for Lymph Node Oligometastases: Real-World Evidence From 90 Consecutive Patients. Frontiers in Oncology. Lausanne: Frontiers Media S.A., 2021, vol. 10, FEB 2021, p. 1-13. ISSN 2234-943X. Available from: https://dx.doi.org/10.3389/fonc.2020.616494.
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Basic information
Original name Stereotactic Body Radiotherapy for Lymph Node Oligometastases: Real-World Evidence From 90 Consecutive Patients
Authors BURKOŇ, Petr (203 Czech Republic, belonging to the institution), Iveta SELINGEROVÁ (203 Czech Republic, guarantor), Marek SLÁVIK (703 Slovakia, belonging to the institution), Petr POSPÍŠIL (203 Czech Republic, belonging to the institution), Lukas BOBEK (203 Czech Republic), Libor KOMINEK (203 Czech Republic), Pavel OSMERA (203 Czech Republic), Tomáš PROCHÁZKA (203 Czech Republic, belonging to the institution), Miroslav VRZAL (203 Czech Republic), Tomáš KAZDA (203 Czech Republic, belonging to the institution) and Pavel ŠLAMPA (203 Czech Republic, belonging to the institution).
Edition Frontiers in Oncology, Lausanne, Frontiers Media S.A. 2021, 2234-943X.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30204 Oncology
Country of publisher Switzerland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 5.738
RIV identification code RIV/00216224:14110/21:00121772
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.3389/fonc.2020.616494
UT WoS 000619460000001
Keywords in English stereotactic body radiotherapy; lymph node metastases; oligometastases; local therapy; radiotherapy
Tags 14110812
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 15/6/2021 08:57.
Abstract
Aims To evaluate the efficacy and toxicity of extracranial stereotactic body radiotherapy (SBRT) in the treatment of oligometastatic lymph node involvement in the mediastinum, retroperitoneum, or pelvis, in a consecutive group of patients from real clinical practice outside clinical trials. Methods A retrospective analysis of 90 patients with a maximum of four oligometastases and various primary tumors (the most common being colorectal cancers). The endpoints were local control of treated metastases (LC), freedom from widespread dissemination (FFWD), progression-free survival (PFS), overall survival (OS), and freedom from systemic treatment (FFST). Acute and delayed toxicities were also evaluated. Results The median follow-up after SBRT was 34.9 months. The LC rate at three and five years was 68.4 and 56.3%, respectively. The observed median FFWD was 14.6 months, with a five-year FFWD rate of 33.7%. The median PFS was 9.4 months; the three-year PFS rate was 19.8%. The median FFST was 14.0 months; the five-year FFST rate was 23.5%. The OS rate at three and five years was 61.8 and 39.3%, respectively. Median OS was 53.1 months. The initial dissemination significantly shortened the time to relapse, death, or activation of systemic treatment-LC (HR 4.8, p < 0.001), FFWD (HR 2.8, p = 0.001), PFS (HR 2.1, p = 0.011), FFST (HR 2.4, p = 0.005), OS (HR 2.2, p = 0.034). Patients classified as having radioresistant tumors noticed significantly higher risk in terms of LC (HR 13.8, p = 0.010), FFWD (HR 3.1, p = 0.006), PFS (HR 3.5, p < 0.001), FFST (HR 3.2, p = 0.003). The multivariable analysis detected statistically significantly worse survival outcomes for initially disseminated patients as well as separately in groups divided according to radiosensitivity. No grade III or IV toxicity was reported. Conclusion Our study shows that targeted SBRT is a very effective and low toxic treatment for oligometastatic lymph node involvement. It can delay the indication of cytotoxic chemotherapy and thus improve and maintain patient quality of life. The aim of further studies should focus on identifying patients who benefit most from SBRT, as well as the correct timing and dosage of SBRT in treatment strategy.
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