A Patient-Level Data Meta-analysis of the Abscopal Effect
Purpose: The abscopal effect is defined when a form of local therapy causes tumor regression of both the target lesion and any untreated tumors. Herein cases of the abscopal effect were systematically reviewed and a patient-level data analysis was performed for clinical predictors of both duration o...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-05-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109422000161 |
| _version_ | 1811257835655266304 |
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| author | Steven J. Hatten, Jr, BS Eric J. Lehrer, MD, MS Jenn Liao, BA Congzhou M. Sha, MS Daniel M. Trifiletti, MD Shankar Siva, MD, PhD Sean M. McBride, MD, MPH David Palma, MD Sheldon L. Holder, MD, PhD Nicholas G. Zaorsky, MD, MS |
| author_facet | Steven J. Hatten, Jr, BS Eric J. Lehrer, MD, MS Jenn Liao, BA Congzhou M. Sha, MS Daniel M. Trifiletti, MD Shankar Siva, MD, PhD Sean M. McBride, MD, MPH David Palma, MD Sheldon L. Holder, MD, PhD Nicholas G. Zaorsky, MD, MS |
| author_sort | Steven J. Hatten, Jr, BS |
| collection | DOAJ |
| description | Purpose: The abscopal effect is defined when a form of local therapy causes tumor regression of both the target lesion and any untreated tumors. Herein cases of the abscopal effect were systematically reviewed and a patient-level data analysis was performed for clinical predictors of both duration of response and survival. Methods and Materials: The Population, Intervention, Control, Outcome, Study (PICOS) design approach, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) literature selection process, and Meta-analysis of Observational Studies in Epidemiology (MOOSE) were used to find articles published before September 2019 in MEDLINE/PubMed and Google Scholar. Inclusion criteria were (1) population: patients with reported abscopal response; (2) intervention: documented treatment(s); (3) control: none; (4) outcomes: overall and progression-free survival; and (5) setting: retrospective case reports. Time from treatment until abscopal response and time from abscopal response until progression/death were calculated. Univariate and multivariate analyses were conducted for survival outcomes. Results: Fifty studies (n = 55 patients) were included. Median age was 65 years (interquartile range [IQR], 58-70) and 62% were male. Fifty-four (98%) patients received radiation therapy, 34 (62%) received radiation therapy alone, 5 (9.1%) underwent surgery, 4 (7.3%) received chemotherapy, and 11 (20%) received immunotherapy. Median total dose was 32 Gy (IQR, 25.5-48 Gy) and median dose per fraction was 3 Gy (IQR, 2-7.2). Median time until abscopal response was 4 months (IQR, 1-5; min 0.5, max 24). At 5 years, overall survival was 63% and distant progression-free survival was 45%. No variables had statistical significance in predicting duration of response or survival. Conclusions: Almost all reported cases of the abscopal response are after radiation therapy; however, there are no known predictors of duration of response or survival in this population. |
| first_indexed | 2024-04-12T18:03:44Z |
| format | Article |
| id | doaj.art-e0335e4b6a2c440b94ea73cfdf9bbb51 |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-04-12T18:03:44Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-e0335e4b6a2c440b94ea73cfdf9bbb512022-12-22T03:22:03ZengElsevierAdvances in Radiation Oncology2452-10942022-05-0173100909A Patient-Level Data Meta-analysis of the Abscopal EffectSteven J. Hatten, Jr, BS0Eric J. Lehrer, MD, MS1Jenn Liao, BA2Congzhou M. Sha, MS3Daniel M. Trifiletti, MD4Shankar Siva, MD, PhD5Sean M. McBride, MD, MPH6David Palma, MD7Sheldon L. Holder, MD, PhD8Nicholas G. Zaorsky, MD, MS9Department of Radiation Oncology, Penn State Cancer Institute, Hershey, PennsylvaniaDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Radiation Oncology, Penn State Cancer Institute, Hershey, PennsylvaniaDepartment of Radiation Oncology, Penn State Cancer Institute, Hershey, PennsylvaniaDepartment of Radiation Oncology, Mayo Clinic, Jacksonville, FloridaSir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, AustraliaDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New YorkDepartment of Radiation Oncology, London Health Sciences Centre, London, Ontario, CanadaDivision of Hematology and Oncology, Brown University Warren Alpert School of Medicine, Providence, Rhode IslandDepartment of Radiation Oncology, Penn State Cancer Institute, Hershey, Pennsylvania; Department of Radiation Oncology, University Hospitals Seidman Cancer Center, Case Western Reserve School of Medicine, Cleveland, Ohio; Corresponding author: Nicholas G. Zaorsky, MD, MSPurpose: The abscopal effect is defined when a form of local therapy causes tumor regression of both the target lesion and any untreated tumors. Herein cases of the abscopal effect were systematically reviewed and a patient-level data analysis was performed for clinical predictors of both duration of response and survival. Methods and Materials: The Population, Intervention, Control, Outcome, Study (PICOS) design approach, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) literature selection process, and Meta-analysis of Observational Studies in Epidemiology (MOOSE) were used to find articles published before September 2019 in MEDLINE/PubMed and Google Scholar. Inclusion criteria were (1) population: patients with reported abscopal response; (2) intervention: documented treatment(s); (3) control: none; (4) outcomes: overall and progression-free survival; and (5) setting: retrospective case reports. Time from treatment until abscopal response and time from abscopal response until progression/death were calculated. Univariate and multivariate analyses were conducted for survival outcomes. Results: Fifty studies (n = 55 patients) were included. Median age was 65 years (interquartile range [IQR], 58-70) and 62% were male. Fifty-four (98%) patients received radiation therapy, 34 (62%) received radiation therapy alone, 5 (9.1%) underwent surgery, 4 (7.3%) received chemotherapy, and 11 (20%) received immunotherapy. Median total dose was 32 Gy (IQR, 25.5-48 Gy) and median dose per fraction was 3 Gy (IQR, 2-7.2). Median time until abscopal response was 4 months (IQR, 1-5; min 0.5, max 24). At 5 years, overall survival was 63% and distant progression-free survival was 45%. No variables had statistical significance in predicting duration of response or survival. Conclusions: Almost all reported cases of the abscopal response are after radiation therapy; however, there are no known predictors of duration of response or survival in this population.http://www.sciencedirect.com/science/article/pii/S2452109422000161 |
| spellingShingle | Steven J. Hatten, Jr, BS Eric J. Lehrer, MD, MS Jenn Liao, BA Congzhou M. Sha, MS Daniel M. Trifiletti, MD Shankar Siva, MD, PhD Sean M. McBride, MD, MPH David Palma, MD Sheldon L. Holder, MD, PhD Nicholas G. Zaorsky, MD, MS A Patient-Level Data Meta-analysis of the Abscopal Effect Advances in Radiation Oncology |
| title | A Patient-Level Data Meta-analysis of the Abscopal Effect |
| title_full | A Patient-Level Data Meta-analysis of the Abscopal Effect |
| title_fullStr | A Patient-Level Data Meta-analysis of the Abscopal Effect |
| title_full_unstemmed | A Patient-Level Data Meta-analysis of the Abscopal Effect |
| title_short | A Patient-Level Data Meta-analysis of the Abscopal Effect |
| title_sort | patient level data meta analysis of the abscopal effect |
| url | http://www.sciencedirect.com/science/article/pii/S2452109422000161 |
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