Disease course of lung oligometastatic colorectal cancer treated with stereotactic body radiotherapy

Nicosia, Luca; Cuccia, Francesco; Mazzola, Rosario; Ricchetti, F.; Figlia, Vanessa; Giaj-Levra, Niccolò; Rigo, Michele; Tomasini, Davide; Pasinetti, Nadia; Corradini, Stefanie; Ruggieri, R.; Alongi, Filippo

doi:10.1007/s00066-020-01627-7

Cited by 25 publications

(14 citation statements)

References 41 publications

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“…We also explored the role of SBRT in postponing the conversion to PMD (43,44), which is not ameanable anymore of local treatment. Nicosia et al (45) reported that the median time to PMD was 25.8 months in CRC patients with lung oligometastases after receiving SBRT. They confirmed that SBRT can postpone the transition to PMD.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

Zhao

Zhu

et al. 2021

Front. Oncol.

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AimTo evaluate the clinical outcomes of metastatic colorectal cancer (mCRC) patients with oligometastases, oligoprogression, or local control of dominant tumors after stereotactic body radiotherapy (SBRT) and establish a nomogram model to predict the prognosis for these patients.Methods and MaterialsA cohort of 94 patients with 162 mCRC metastases was treated with SBRT at a single institution. Treatment indications were oligometastases, oligoprogression, and local control of dominant tumors. End points of this study were the outcome in terms of progression-free survival (PFS), overall survival (OS), local progression (LP), and cumulative incidence of starting or changing systemic therapy (SCST). In addition, univariate and multivariable analyses to assess variable associations were performed. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve.ResultsMedian PFS were 12.6 months, 6.8 months, and 3.7 months for oligometastases, oligoprogression, and local control of dominant tumors, respectively. 0-1 performance status, < 10 ug/L pre-SBRT CEA, and ≤ 2 metastases were significant predictors of higher PFS on multivariate analysis. Median OS were 40.0 months, 26.1 months, and 6.5 months for oligometastases, oligoprogression, and local control of dominant tumors, respectively. In the multivariate analysis of the cohort, the independent factors for survival were indication, performance status, pre-SBRT CEA, and PTV, all of which were selected into the nomogram. The calibration curve for probability of survival showed the good agreement between prediction by nomogram and actual observation. The C-index of the nomogram for predicting survival was 0.848.ConclusionsSBRT for metastases derived from colorectal cancer offered favorable survival and symptom palliation without significant complications. The proposed nomogram could provide individual prediction of OS for patients with mCRC after SBRT.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

Zhao

Zhu

et al. 2021

Front. Oncol.

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“…Unlike previous experiences, we have not recorded a survival advantage in those patients who developed a sequential oligometastatic progression, further treated with a second course of SBRT. [21,22] This evidence may raise the issue of the real role of focal treatments in this setting, suggesting a different natural history of gynecological malignancies when compared to other scenarios, as also highlighted by the sub-optimal PFS rates of most of the published studies concerning gynecological oligometastases.…”

Section: Discussionmentioning

confidence: 99%

The use of SBRT in the management of oligometastatic gynecological cancer: report of promising results in terms of tolerability and clinical outcomes

Cuccia

Pastorello

Vitale

et al. 2021

J Cancer Res Clin Oncol

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BackgroundThe use of stereotactic radiotherapy (SBRT) for oligometastases is supported by several literature studies, but in the setting of gynecological malignancies, this scenario remains quite unexplored. This study reports a preliminary assessment of clinical outcomes in a cohort of 40 patients with oligometastatic gynecological neoplasms. MethodsRadiotherapy was delivered in 3-10 fractions with VMAT-IGRT technique. Toxicity was retrospectively collected according to CTCAE v4.0. Data were retrospectively collected and analyzed. Univariate and multivariate analysis were performed for assessing any potential predictive factor for clinical outcomes. ResultsA total of 63 oligometastases were treated from December 2014 to February 2021. Median age was 63 years (range, 30-89). Most frequent primary tumors were ovarian cancer in 42.5% and endometrium cancer in 42.5%. With a median follow-up of 27 months (range, 6-69), no local failures were observed, our progression-free survival rates were 43.6% and 23% at one and 2 years, respectively, while 1-and 2-years overall survival rates were both 70%. No acute or late G≥2 adverse events were observed. ConclusionsIn our experience, SBRT for oligometastatic gynecological malignancies resulted in promising results in terms of clinical outcomes, with excellent local control and no evidence of severe toxicity, highilighting the effectiveness of this therapeutic option. Prospective studies to further explore this approach in this setting are advocated.

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“… N.A. LC: -BED10 ≥ 75 Gy (HR 0.12, p-value 0.0004) -PTV volume < 42 cm3 (HR 0.46, p-value 0.02) Nicosia, 34 2020 Retrospective 38/107 75 Lung 30–70Gy/ 3–10 fr 105 28 91.5% (1y) 80% (2yrs) 39.5 mos (median) 7 mos (median) N.A. PFS: -BRAF wild-type (p-value 0.046) N.A.…”

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

“… 26 , 29 Nicosia et al found at univariate analysis that BRAF wildtype status was predictive for a longer local progression-free survival. 34 …”

Section: Sabr-related Predictors Of Response In Primary Tumor-specific Oligometastatic Diseasementioning

confidence: 99%

Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

Franceschini

Teriaca

Dominici

et al. 2021

CMAR

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Oligometastatic patients are a heterogeneous and yet not well-defined population. The actual definition identifies as oligometastatic, patients with 1-5 metastases in 1-3 different organs. However, only a proportion of these patients are "true" oligometastatic and therefore derive some kinds of benefit from local ablative approaches like stereotactic ablative radiation therapy (SABR). Since SABR is an easily accessible, effective and welltolerated treatment, it is widely employed in the oligometastatic scenarios, without a particular focus on selection criteria. However, it should be crucial to identify predictive and prognostic features that could be clinically implemented. Therefore, we conducted this narrative review of the available literature to summarize all clinical, radiomic, genetic and epigenetic features found to be predictive of overall survival, progression-free survival or local control of oligometastatic patients treated with SABR.

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Disease course of lung oligometastatic colorectal cancer treated with stereotactic body radiotherapy

Cited by 25 publications

References 41 publications

Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors

The use of SBRT in the management of oligometastatic gynecological cancer: report of promising results in terms of tolerability and clinical outcomes

Knowing When to Use Stereotactic Ablative Radiation Therapy in Oligometastatic Cancer

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