Outcomes after stereotactic body radiotherapy for lung tumors, with emphasis on comparison of primary lung cancer and metastatic lung tumors

Yamamoto, Takaya; Jingu, Keiichi; Shirata, Yuko; Koto, Masashi; Matsushita, Haruo; Sugawara, Toshiyuki; Kubozono, Masaki; Umezawa, Rei; Abe, Keiko; Ishikawa, Yojiro; Kozumi, Maiko; Takahashi, Noriyoshi; Takeda, Ken; Takai, Yoshihiro

doi:10.1186/1471-2407-14-464

Cited by 28 publications

(29 citation statements)

References 28 publications

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“…The tumor control rate at the treated site (in this series the crude rate is 92.5%) has not been considered as an appropriate endpoint in the present study, because there are several potential biases in local control definition and in retrospective evaluation. In previous reports, local control rates after SABR for CRC lung metastases seemed to be lower than for other metastatic tumors, but with small sample sizes and short follow-up (16,17). Moreover, local control did not affect survival in any surgical or RFA series (also taking into account the dissimilar definition of local control across studies).…”

Section: Discussionmentioning

confidence: 90%

Stereotactic Ablative Radiation Therapy as First Local Therapy for Lung Oligometastases From Colorectal Cancer: A Single-Institution Cohort Study

Filippi

Badellino

Ceccarelli

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 90%

Stereotactic Ablative Radiation Therapy as First Local Therapy for Lung Oligometastases From Colorectal Cancer: A Single-Institution Cohort Study

Filippi

Badellino

Ceccarelli

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…This concept was confirmed by another study (6), and extrapolated for MLLs (8,16). However, this dogma is based on chi-square test (15) and log rank (6) univariate analysis and remains therefore controversial (17).…”

Section: Discussionmentioning

confidence: 55%

“…Conversely, PLLs were also included in studies for MLLs. In a recent published systematic review (11), all five studies on stereotactic radiosurgery included lesions of pulmonary origins with a median percentage of 34% (range, 6-51%), and 11/13 studies of SABR included such lesions with a median percentage of 22% (range, 8-62% (8), in which the LC between MLLs and PLLs was significantly different (P=0.01), and the difference in LC for MLLs from colorectal cancer was significant (P=0.022). In the presented study, LR occurred in lung metastases from ovary (n=2), sarcoma (n=2), and head and neck cancer (n=2).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with MLLs may gain benefit from a high local control (LC) of their oligometastases, if they are at a very low risk to develop further distant metastases (5). There have been a few studies that addressed the issue of comparison between MLLs and PLLs patients (5)(6)(7)(8). In contrast to them, lung lesions of pulmonary origin, i.e., metastases from lung cancer were strictly excluded from the MLLs group.…”

Section: Introductionmentioning

confidence: 99%

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Retrospective analysis of stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) in comparison with a contemporaneous cohort of primary lung lesions (PLLs)

et al. 2017

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Background: The net benefit from local ablative therapy for pulmonary oligometastases remains unknown.The outcomes of stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) were analyzed retrospectively and compared with those of SABR for primary lung lesions (PLLs). Methods: Medical records of patients treated with lung SABR between 2011 and 2014 were retrospectively reviewed. Basic patient, lesion and treatment characteristics were compared using the Pearson chi-square test for categorical and Mann-Whitney U test for continuous variables. To estimate the rates of local control (LC), progression-free survival (PFS), survival after the first progression post-SABR (SAPF) and overall survival (OS), the Kaplan-Meier method was used, and the differences between groups were assessed by means of the log rank test. The uni-and multivariate Cox proportional hazards regression model was used to identify predictive factors for these endpoints. Results: Twenty-nine MLLs in 18 consecutive patients and 51 PLLs in 42 patients were treated stereotactically and included in the study. Median follow-up was 14 months (range, 4-40 months). Although patients with MLLs had a significantly better cardiopulmonary function (P=0.0001), more conservative dosefractionation schedules were prescribed (P=0.0001), but this did not result in a significant difference in LC (P=0.98), PFS (P=0.06) and OS (P=0.14). Multivariate analysis revealed that the dose per fraction (≥ or <12 Gy) was an independent predictor for LC (P=0.02) and PFS (P=0.01) for the whole population, and for PFS (P=0.02) in the PLLs group. Late toxicities ≥ G2 occurred in six patients with PLLs, compared with none in the metastatic group. Conclusions: SABR for MLLs was as successful as for PLLs with respect to LC and OS with lower longterm toxicity in patients with MLLs. Dose per fraction ≥12 Gy turned out to be an independent, favorable prognostic factor. IntroductionBased on conceptual theories of breast cancer growth and dissemination, Hellman and Weichselbaum inferred the existence of a clinically and biologically relevant group of oligometastatic patients, in whom aggressive local therapy may prolong survival and even be a curative treatment option (1). The incentive for using stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) came from favorable results of surgical removal of oligometastases in different types of solid tumors (2). High rates of survival in treated compared with untreated patients have also been demonstrated for lung metastasectomy (3). However, the temporal and locational burden of oligometastatic state remains blurred and diffuse and-until now-no clear guidelines have been defined for the selection of patients who would really benefit from local ablative treatment.During the past decade, SABR emerged as a new standard of care for medically inoperable patients with early stage non-small-cell lung cancer. For oligometastatic diseases the benefit from SABR has been extrapolated from the experience with pr...

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“…The SBRT technique used in our institution has been reported several times [8–9]. The treatment procedure is summarized in Table 2.…”

Section: Methodsmentioning

confidence: 99%

Metabolic tumor volume on FDG-PET/CT is a possible prognostic factor for Stage I lung cancer patients treated with stereotactic body radiation therapy: a retrospective clinical study

Takahashi

Yamamoto

Matsushita

et al. 2016

Journal of Radiation Research

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The aim of this study was to determine whether metabolic tumor volume (MTV) and total lesion glycolysis (TLG) are associated with outcomes in Stage I lung cancer patients treated with stereotactic body radiation therapy (SBRT). Thirty-eight patients underwent [18F] fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) within 60 days before SBRT at our institution between January 2001 and December 2011. The maximum standardized uptake value (SUVmax), MTV2, MTV4, MTV6, TLG40%, TLG50% and TLG60% were calculated. Prognostic factors for overall survival (OS) and local control (LC) were analyzed using Cox's proportional hazards model, and survival curves were calculated using the Kaplan–Meier method. Receiver operating characteristics (ROC) curves of PET parameters for OS and LC were calculated. The median follow-up period for survivors was 37.7 months. Three-year OS and LC rates were 56.4% and 70.5%, respectively, and 5-year OS and LC rates were 36.8% and 70.5%, respectively. In univariate analyses, tumor diameter (P = 0.019), single dose ≥10 Gy (P = 0.017), MTV2 (P = 0.030) and MTV4 (P = 0.048) were significant predictors for OS. Tumor diameter (P < 0.001), single dose ≥10 Gy (P = 0.007), SUVmax (P = 0.035), MTV2 (P < 0.001), MTV4 (P = 0.003), MTV6 (P = 0.017), TLG40% (P < 0.001), TLG50% (P = 0.001) and TLG60% (P = 0.003) were significant predictors for LC. SUVmax was not a significant predictor for OS. We made the ROC curves at PET parameters, and the largest area under the curve value for OS was MTV2 and for LC was TLG40%. Tumor diameter, single dose ≥10 Gy, MTV2 and MTV4 are prognostic factors for OS and LC rates and MTV2 is a better prognostic factor for OS than other PET parameters.

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Outcomes after stereotactic body radiotherapy for lung tumors, with emphasis on comparison of primary lung cancer and metastatic lung tumors

Cited by 28 publications

References 28 publications

Stereotactic Ablative Radiation Therapy as First Local Therapy for Lung Oligometastases From Colorectal Cancer: A Single-Institution Cohort Study

Stereotactic Ablative Radiation Therapy as First Local Therapy for Lung Oligometastases From Colorectal Cancer: A Single-Institution Cohort Study

Retrospective analysis of stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) in comparison with a contemporaneous cohort of primary lung lesions (PLLs)

Metabolic tumor volume on FDG-PET/CT is a possible prognostic factor for Stage I lung cancer patients treated with stereotactic body radiation therapy: a retrospective clinical study

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