Maladie oligométastatique, un nouveau concept : irradiation en conditions stéréotaxiques de métastases pulmonaires. Revue de la littérature

Hatime, M.; Elmorabit, B.; Elkhoti, Y.; Touch, Sothea; Tanguy, R.; Mornex, F.

doi:10.1016/j.canrad.2012.07.184

Cited by 18 publications

(3 citation statements)

References 53 publications

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“…Extrahepatic metastasis is one of the most important predictors of poor OS 9 , 10 . Several studies have investigated therapies for oligometastases, with promising results 11 - 13 . Niibe et al reported a 2-year OS rate of 65.7% in patients with pulmonary oligometastases 12 .…”

Section: Discussionmentioning

confidence: 99%

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Sorafenib Monotherapy Versus Sorafenib Combined with Regional Therapies for Hepatocellular Carcinoma Patients with Pulmonary Oligometastases: A Propensity Score-matched Analysis

Chen

Zhang

et al. 2018

J. Cancer

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Background: Sorafenib has been recommended as the standard therapy for advanced HCC with extrahepatic metastasis. The purpose of this retrospective study was to investigate the difference in overall survival (OS) between treatments with sorafenib combined with regional therapies versus sorafenib monotherapy in hepatocellular carcinoma (HCC) patients with pulmonary oligometastases.Methods: The study retrospectively enrolled 95 consecutive patients who underwent sorafenib therapy. A combined group (CG) of 40 patients received regional therapy in addition to sorafenib, and a monotherapy group (MG) of 55 patients received only sorafenib. OS was the primary endpoint, and time to progression (TTP) was the secondary endpoint. Subgroup analysis was further performed to evaluate the differences between the two groups. A propensity score-matched analysis was performed to overcome the bias.Results: Median OS was significantly longer in the CG than in the MG (18.37 vs. 7.13 months; P = 0.002). Multivariate analysis identified three baseline characteristics that were prognostic indicators of OS: macrovascular invasion, regional therapy, and alpha-fetoprotein. Median TTP was significantly longer in the CG than in the MG (2.93 vs. 2.23 months; P = 0.004). Further multivariate analysis showed alpha-fetoprotein, total bilirubin, and regional therapy as prognostic indicators of TTP. After propensity score matching, 34 paired patients constituted each group. Patients in the adjusted CG showed a longer OS and TTP than those in the adjusted MG (OS: 18.37 vs. 7.37 months, P = 0.015; TTP: 3.12 vs. 2.265 months, P = 0.009). Multivariate analysis showed that combining regional therapies was still a prognostic indicator of OS (P = 0.01) and TTP (P = 0.001).Conclusions: Sorafenib combined with regional therapies may be associated with prolonged OS and TTP in HCC patients with pulmonary oligometastases compared with sorafenib monotherapy.

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Section: Discussionmentioning

confidence: 99%

“…Whether combining PMT and sorafenib treatment could prolong survival further in comparison with sorafenib monotherapy remains unclear. The other choice for pulmonary therapy is stereotactic body radiotherapy, which has been reported effective and safe in pulmonary oligometastases 11 , 32 .…”

Section: Discussionmentioning

confidence: 99%

Sorafenib Monotherapy Versus Sorafenib Combined with Regional Therapies for Hepatocellular Carcinoma Patients with Pulmonary Oligometastases: A Propensity Score-matched Analysis

Chen

Zhang

et al. 2018

J. Cancer

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“…La radiothérapie en conditions sté-réotaxiques est un traitement reconnu par la Haute Autorité de santé (HAS) pour les tumeurs bronchopulmonaires primitives de stade T1/T2 N0 M0 et les métastases à croissance lente avec tumeur primitive contrôlée [3,5,6]. L'indication de radiothérapie en conditions stéréotaxiques est optimale pour les tumeurs de stade I ou II, classées T1N0M0 et T2aN0M0, de 5 cm ou moins de grand diamètre.…”

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