Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?

Aims: To retrospectively review the toxicity and early outcome data from patients who have received stereotactic body radiotherapy (SBRT) for extracranial oligometastases at a single UK institution. Materials and methods: Eligible patients had ≤3 extracranial metastases and performance status ≤2. Pr...

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Main Authors: Aitken, K, Tree, A, Thomas, K, Nutting, C, Hawkins, M, Tait, D, Mandeville, H, Ahmed, M, Lalondrelle, S, Miah, A, Taylor, A, Ross, G, Khoo, V, van As, N
Format: Journal article
Published: Elsevier 2015
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author Aitken, K
Tree, A
Thomas, K
Nutting, C
Hawkins, M
Tait, D
Mandeville, H
Ahmed, M
Lalondrelle, S
Miah, A
Taylor, A
Ross, G
Khoo, V
van As, N
author_facet Aitken, K
Tree, A
Thomas, K
Nutting, C
Hawkins, M
Tait, D
Mandeville, H
Ahmed, M
Lalondrelle, S
Miah, A
Taylor, A
Ross, G
Khoo, V
van As, N
author_sort Aitken, K
collection OXFORD
description Aims: To retrospectively review the toxicity and early outcome data from patients who have received stereotactic body radiotherapy (SBRT) for extracranial oligometastases at a single UK institution. Materials and methods: Eligible patients had ≤3 extracranial metastases and performance status ≤2. Prior systemic therapy and radical treatment of oligometastastic relapse with any standard treatment modality was permitted. Patients with synchronous metastatic disease were excluded unless they had evidence of controlled primary disease after radical therapy. Follow-up consisted of clinical examination, biochemical and radiological assessments in accordance with standard clinical care. Progression events were defined using RECIST. Toxicity was evaluated using CTCAE v4.0. Local control, progression-free survival (PFS), freedom from widespread distant metastasis (defined as disease not amenable to further radical salvage therapy) and overall survival were calculated. Results: Between July 2011 and April 2014, 73 patients with 87 metastases received SBRT (range 1-3 per patient). The median follow-up was 14.5 months (range 0-26.4). The median PFS was 14.5 months (1 year PFS 57%, 2 year 28%); 1 year overall survival 96%, 2 year 79.8%; 2 year local control 88%. At 2 years, 46% of patients were free from widespread distant metastases. No≥grade 3 acute or late toxicity was observed. Conclusion: At this time point, observed toxicity is minimal with excellent local control rates. This promising treatment paradigm requires further investigation in the context of a randomised controlled trial to establish if the addition of SBRT to standard care improves survival outcomes.
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spelling oxford-uuid:6cb2522c-9e9b-4c34-954f-53df1fdc5a6a2022-03-26T19:12:48ZInitial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6cb2522c-9e9b-4c34-954f-53df1fdc5a6aSymplectic Elements at OxfordElsevier2015Aitken, KTree, AThomas, KNutting, CHawkins, MTait, DMandeville, HAhmed, MLalondrelle, SMiah, ATaylor, ARoss, GKhoo, Vvan As, NAims: To retrospectively review the toxicity and early outcome data from patients who have received stereotactic body radiotherapy (SBRT) for extracranial oligometastases at a single UK institution. Materials and methods: Eligible patients had ≤3 extracranial metastases and performance status ≤2. Prior systemic therapy and radical treatment of oligometastastic relapse with any standard treatment modality was permitted. Patients with synchronous metastatic disease were excluded unless they had evidence of controlled primary disease after radical therapy. Follow-up consisted of clinical examination, biochemical and radiological assessments in accordance with standard clinical care. Progression events were defined using RECIST. Toxicity was evaluated using CTCAE v4.0. Local control, progression-free survival (PFS), freedom from widespread distant metastasis (defined as disease not amenable to further radical salvage therapy) and overall survival were calculated. Results: Between July 2011 and April 2014, 73 patients with 87 metastases received SBRT (range 1-3 per patient). The median follow-up was 14.5 months (range 0-26.4). The median PFS was 14.5 months (1 year PFS 57%, 2 year 28%); 1 year overall survival 96%, 2 year 79.8%; 2 year local control 88%. At 2 years, 46% of patients were free from widespread distant metastases. No≥grade 3 acute or late toxicity was observed. Conclusion: At this time point, observed toxicity is minimal with excellent local control rates. This promising treatment paradigm requires further investigation in the context of a randomised controlled trial to establish if the addition of SBRT to standard care improves survival outcomes.
spellingShingle Aitken, K
Tree, A
Thomas, K
Nutting, C
Hawkins, M
Tait, D
Mandeville, H
Ahmed, M
Lalondrelle, S
Miah, A
Taylor, A
Ross, G
Khoo, V
van As, N
Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?
title Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?
title_full Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?
title_fullStr Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?
title_full_unstemmed Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?
title_short Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm?
title_sort initial uk experience of stereotactic body radiotherapy for extracranial oligometastases can we change the therapeutic paradigm
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