Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases
Abstract Background Our aim is to report treatment efficacy and toxicity of patients treated by robotic (Cyberknife®) stereotactic body radiotherapy (SBRT) for oligorecurrent lung metastases (ORLM). Additionally we wanted to evaluate influence of tumor, patient and treatment related parameters on lo...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-020-06906-1 |
| _version_ | 1818116000396083200 |
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| author | Patrick Berkovic Akos Gulyban Gilles Defraene Laurie Swenen David Dechambre Paul Viet Nguyen Nicolas Jansen Carole Mievis Pierre Lovinfosse Levente Janvary Maarten Lambrecht Gert De Meerleer |
| author_facet | Patrick Berkovic Akos Gulyban Gilles Defraene Laurie Swenen David Dechambre Paul Viet Nguyen Nicolas Jansen Carole Mievis Pierre Lovinfosse Levente Janvary Maarten Lambrecht Gert De Meerleer |
| author_sort | Patrick Berkovic |
| collection | DOAJ |
| description | Abstract Background Our aim is to report treatment efficacy and toxicity of patients treated by robotic (Cyberknife®) stereotactic body radiotherapy (SBRT) for oligorecurrent lung metastases (ORLM). Additionally we wanted to evaluate influence of tumor, patient and treatment related parameters on local control (LC), lung and distant progression free- (lung PFS/Di-PFS) and overall survival (OS). Methods Consecutive patients with up to 5 ORLM (confirmed by FDG PET/CT) were included in this study. Intended dose was 60Gy in 3 fractions (prescribed to the 80% isodose volume). Patients were followed at regular intervals and tumor control and toxicity was prospectively scored. Tumor, patient and treatment data were analysed using competing risk- and Cox regression. Results Between May 2010 and March 2016, 104 patients with 132 lesions were irradiated from primary lung carcinoma (47%), gastro-intestinal (34%) and mixed primary histologies (19%). The mean tumor volume was 7.9 cc. After a median follow up of 22 months, the 1, 2 and 3 year LC rate (per lesion) was 89.3, 80.0 and 77.8% respectively. The corresponding (per patient) 1, 2 and 3 years lung PFS were 66.3, 50.0, 42.6%, Di-PFS were 80.5, 64.4, 60.6% and OS rates were 92.2, 80.9 and 72.0% respectively. On univariable analysis, gastro-intestinal (GI) as primary tumor site showed a significant superior local control versus the other primary tumor sites. For OS, significant variables were primary histology and primary tumor site with a superior OS for patients with metastases of primary GI origin. LC was significantly affected by the tumor volume, physical and biologically effective dose coverage. Significant variables in multivariable analysis were BED prescription dose for LC and GI as primary site for OS. The vast majority of patients developed no toxicity or grade 1 acute and late toxicity. Acute and late grade 3 radiation pneumonitis (RP) was observed in 1 and 2 patients respectively. One patient with a centrally located lesion developed grade 4 RP and died due to possible RT-induced pulmonary hemorrhage. Conclusions SBRT is a highly effective local therapy for oligorecurrent lung metastases and could achieve long term survival in patients with favourable prognostic features. |
| first_indexed | 2024-12-11T04:15:33Z |
| format | Article |
| id | doaj.art-8a20298cd12b416a8edc6bf2a2352e56 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-11T04:15:33Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-8a20298cd12b416a8edc6bf2a2352e562022-12-22T01:21:15ZengBMCBMC Cancer1471-24072020-05-012011910.1186/s12885-020-06906-1Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastasesPatrick Berkovic0Akos Gulyban1Gilles Defraene2Laurie Swenen3David Dechambre4Paul Viet Nguyen5Nicolas Jansen6Carole Mievis7Pierre Lovinfosse8Levente Janvary9Maarten Lambrecht10Gert De Meerleer11Department of Radiation Oncology, University Hospitals LeuvenDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospitals LeuvenDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospital of LiègeDepartment of Radiation Oncology, University Hospitals LeuvenDepartment of Radiation Oncology, University Hospitals LeuvenAbstract Background Our aim is to report treatment efficacy and toxicity of patients treated by robotic (Cyberknife®) stereotactic body radiotherapy (SBRT) for oligorecurrent lung metastases (ORLM). Additionally we wanted to evaluate influence of tumor, patient and treatment related parameters on local control (LC), lung and distant progression free- (lung PFS/Di-PFS) and overall survival (OS). Methods Consecutive patients with up to 5 ORLM (confirmed by FDG PET/CT) were included in this study. Intended dose was 60Gy in 3 fractions (prescribed to the 80% isodose volume). Patients were followed at regular intervals and tumor control and toxicity was prospectively scored. Tumor, patient and treatment data were analysed using competing risk- and Cox regression. Results Between May 2010 and March 2016, 104 patients with 132 lesions were irradiated from primary lung carcinoma (47%), gastro-intestinal (34%) and mixed primary histologies (19%). The mean tumor volume was 7.9 cc. After a median follow up of 22 months, the 1, 2 and 3 year LC rate (per lesion) was 89.3, 80.0 and 77.8% respectively. The corresponding (per patient) 1, 2 and 3 years lung PFS were 66.3, 50.0, 42.6%, Di-PFS were 80.5, 64.4, 60.6% and OS rates were 92.2, 80.9 and 72.0% respectively. On univariable analysis, gastro-intestinal (GI) as primary tumor site showed a significant superior local control versus the other primary tumor sites. For OS, significant variables were primary histology and primary tumor site with a superior OS for patients with metastases of primary GI origin. LC was significantly affected by the tumor volume, physical and biologically effective dose coverage. Significant variables in multivariable analysis were BED prescription dose for LC and GI as primary site for OS. The vast majority of patients developed no toxicity or grade 1 acute and late toxicity. Acute and late grade 3 radiation pneumonitis (RP) was observed in 1 and 2 patients respectively. One patient with a centrally located lesion developed grade 4 RP and died due to possible RT-induced pulmonary hemorrhage. Conclusions SBRT is a highly effective local therapy for oligorecurrent lung metastases and could achieve long term survival in patients with favourable prognostic features.http://link.springer.com/article/10.1186/s12885-020-06906-1Lung-Oligometastases-Oligorecurrence-Cyberknife-prognostic factors-outcome |
| spellingShingle | Patrick Berkovic Akos Gulyban Gilles Defraene Laurie Swenen David Dechambre Paul Viet Nguyen Nicolas Jansen Carole Mievis Pierre Lovinfosse Levente Janvary Maarten Lambrecht Gert De Meerleer Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases BMC Cancer Lung-Oligometastases-Oligorecurrence-Cyberknife-prognostic factors-outcome |
| title | Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases |
| title_full | Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases |
| title_fullStr | Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases |
| title_full_unstemmed | Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases |
| title_short | Stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases |
| title_sort | stereotactic robotic body radiotherapy for patients with oligorecurrent pulmonary metastases |
| topic | Lung-Oligometastases-Oligorecurrence-Cyberknife-prognostic factors-outcome |
| url | http://link.springer.com/article/10.1186/s12885-020-06906-1 |
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