Nomogram based overall survival prediction in stereotactic body radiotherapy for oligo-metastatic lung disease

Tanadini‐Lang, Stephanie; Rieber, Juliane; Filippi, Andrea Riccardo; Fode, Mette Marie; Streblow, Jan; Adebahr, S.; Andratschke, Nicolaus; Blanck, Oliver; Boda-Heggemann, Judit; Duma, Marciana-Nona; Eble, Michael J.; Ernst, Iris; Flentje, Michael; Gerum, S.; Hass, Peter; Henkenberens, Christoph; Hildebrandt, Guido; Imhoff, Detlef; Kahl, H.; Klass, Natalie Désirée; Krempien, Robert; Lohaus, Fabian; Petersen, Cordula; Schrade, E.; Wendt, Thomas; Wittig, Andrea; Høyer, Morten; Ricardi, Umberto; Sterzing, Florian; Gückenberger, Matthias

doi:10.1016/j.radonc.2017.01.003

Cited by 55 publications

(42 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The largest multi-institutional study that treated patients of pulmonary oligometastases with SBRT reported 2-year and 5-year OS of 53% and 24%, respectively [27]. In this study, 5-year OS was 24% in the DEGRO cohort and reached 31% and 38% in the Aarhus and Torino cohorts, respectively [27]. Although treating a different subset of patients with oligometastatic disease, our results are comparable with the surgical series [3,7].…”

Section: Discussionsupporting

confidence: 66%

“…Survival achieved in our cohort of patients is particularly encouraging as the majority of patients had multiple comorbidities; more than 42% had extra-pulmonary metastases, 75% had more than one metastases, and more than half of the patients were not treated with chemotherapy before the start of SBRT. The largest multi-institutional study that treated patients of pulmonary oligometastases with SBRT reported 2-year and 5-year OS of 53% and 24%, respectively [27]. In this study, 5-year OS was 24% in the DEGRO cohort and reached 31% and 38% in the Aarhus and Torino cohorts, respectively [27].…”

Section: Discussionmentioning

confidence: 54%

See 1 more Smart Citation

Survival and prognostic factors of pulmonary oligometastases treated with stereotactic body radiotherapy

et al. 2018

View full text Add to dashboard Cite

Background: Stereotactic body radiotherapy (SBRT) for pulmonary oligometastatic disease achieves excellent treatment outcomes in terms of local control and toxicity. Patients treated with SBRT are often elderly and have multiple co-morbidities. This subset of patients may experience different survival as compared to young and fit patients subjected to radical metastasectomies. The purpose of this retrospective study was to evaluate OS and identify factors associated with OS for inoperable pulmonary oligometastases treated with SBRT. Material and methods: Criteria used for selection of patients with oligometastases included: metastases limited to 2 organs and in total 5 metastases at the time of treatment. Peripheral tumors were treated with 51 Gy to 60 Gy in three fractions or a single fraction of 30 Gy. Central tumors received a dose of 45-60 Gy in 5-8 fractions. Survival probabilities were estimated by means of Kaplan-Meier method and the relation between potential prognostic factors and OS was studied by means of Cox regression analyses. Results: In this study, 327 inoperable pulmonary oligometastases in 206 patients were treated with SBRT from the year 2005 to 2015. Primary sites of pulmonary oligometastases included colorectal carcinoma (n ¼ 118), lung carcinoma (n ¼ 36), melanoma (n ¼ 11), sarcoma (n ¼ 10), breast carcinoma (n ¼ 7), and other tumors sites (n ¼ 24). Median follow-up was 26 months. Median survival was 33 months. The 2-year and 5-year OS rates were 63% and 30%, respectively. On univariate analysis synchronous oligometastases (HR 0.59) and colorectal primary (HR 0.64) were associated with improved OS. On multivariable analysis synchronous oligometastases (HR 0.56), colorectal primary (HR 0.62) and tumor size <3 cm (HR 0.68) were independently associated with OS. Conclusions: SBRT to pulmonary oligometastases was associated with a 2-year OS of 63%. Tumor size <3 cm and colorectal primary tumors experienced improved OS compared to tumors >3 cm and noncolorectal primary tumors.

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 54%

Survival and prognostic factors of pulmonary oligometastases treated with stereotactic body radiotherapy

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Tanadini‐Lang et al . evaluated prognostic factors for OS and developed a nomogram aimed at predicting OS after SBRT for pulmonary metastases . According to their study, OS was influenced by the size of the pulmonary metastatic lesion, whether synchronous metastasis was present, and whether the primary lesion was controlled.…”

Section: Discussionmentioning

confidence: 99%

“…Tanadini-Lang et al evaluated prognostic factors for OS and developed a nomogram aimed at predicting OS after SBRT for pulmonary metastases. 11 According to their study, OS was influenced by the size of the pulmonary metastatic lesion, whether synchronous metastasis was present, and whether the primary lesion was controlled. Although patients with large metastatic lesions and synchronous metastases (which are considered contraindications to metastasectomy) were more prevalent in the SBRT group in our study, their OS rates were comparable to those in the surgery group.…”

Section: Discussionmentioning

confidence: 99%

“…8 However, the criteria for selecting the patients for whom local treatment is appropriate have not yet been defined, particularly as metastatic cancer patients usually experience distant site failure. [9][10][11] In some patients, local treatment may result in increased toxicity without improved therapeutic outcomes. 12 Therefore, the optimal local therapy remains unclear.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of stereotactic body radiotherapy versus metastasectomy outcomes in patients with pulmonary metastases

et al. 2018

View full text Add to dashboard Cite

BackgroundWe compared the treatment outcomes of stereotactic body radiotherapy (SBRT) and metastasectomy in patients with pulmonary metastases.MethodsTwenty‐one patients received SBRT (total radiation doses 60 Gy in 3 fractions or 48 Gy in 4 fractions) and 30 underwent metastasectomy, most (93.3%) with wedge resection. The patients were followed for a median of 13.7 months. The tumor size in the SBRT group was larger than in the metastasectomy group (median 2.5 vs. 1.25 cm; P = 0.015). Patients with synchronous metastases were more likely to be treated with SBRT than with metastasectomy (P = 0.006).ResultsThere was no significant difference in the local control rates of the treatment groups (P = 0.163). Progression‐free survival (PFS) was longer in the metastasectomy than in the SBRT group (P = 0.02), with one and two‐year PFS rates of 51.1% and 46% versus 23.8% and 11.9%, respectively. The one and two‐year overall survival (OS) rates were 95% and 81.8% in the metastasectomy group and 79.5% and 68.2%, in the SBRT group, respectively. In multivariate analysis, synchronous metastasis was related to poor PFS, and tumor size was the most significant factor affecting OS. There were no significant differences in PFS and OS between treatment groups after dividing patients according to the presence or absence of synchronous metastases.ConclusionsSBRT is considered a suitable local modality against pulmonary metastases; however, patients with synchronous metastases are only likely to obtain a small benefit from local treatment with either SBRT or surgery.

show abstract

Indications and Techniques for Anterior Thoracolumbar Resections and Reconstructions

Elder

Ishida

Wolinsky³

2018

Metastatic Spine Disease

View full text Add to dashboard Cite

Nomogram based overall survival prediction in stereotactic body radiotherapy for oligo-metastatic lung disease

Cited by 55 publications

References 27 publications

Survival and prognostic factors of pulmonary oligometastases treated with stereotactic body radiotherapy

Survival and prognostic factors of pulmonary oligometastases treated with stereotactic body radiotherapy

Comparison of stereotactic body radiotherapy versus metastasectomy outcomes in patients with pulmonary metastases

Indications and Techniques for Anterior Thoracolumbar Resections and Reconstructions

Contact Info

Product

Resources

About