Phase 3 Multi-Center, Prospective, Randomized Trial Comparing Single-Dose 24 Gy Radiation Therapy to a 3-Fraction SBRT Regimen in the Treatment of Oligometastatic Cancer

Zeléfsky, Michael J.; Yamada, Yoshiya; Greco, Carlo; Lis, Eric; Schöder, Heiko; Lobaugh, Stephanie; Zhang, Zhigang; Braunstein, Steve; Bilsky, Mark H.; Powell, Simon N.; Kolesnick, Richard; Fuks, Zvi

doi:10.1016/j.ijrobp.2021.01.004

Cited by 83 publications

(53 citation statements)

References 30 publications

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“…The purpose will be to clarify the role of vascular damage in single-fraction high-dose radiotherapy ( 72 ). One hypothesis of the clinical success of single-dose radiotherapy ( 73 ), even compared to hypofractionation ( 74 ), is the vascular dysfunction ( 75 ) via ischemia/reperfusion injury ( 76 ). Other authors contend that the increased effectiveness of single-fraction is well explained by the classical radiobiology in terms of reduced repair, i.e.…”

Section: Radiobiologymentioning

confidence: 99%

Radioactive Beams for Image-Guided Particle Therapy: The BARB Experiment at GSI

Boscolo¹,

Kostyleva²,

Safari³

et al. 2021

Front. Oncol.

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Several techniques are under development for image-guidance in particle therapy. Positron (β+) emission tomography (PET) is in use since many years, because accelerated ions generate positron-emitting isotopes by nuclear fragmentation in the human body. In heavy ion therapy, a major part of the PET signals is produced by β+-emitters generated via projectile fragmentation. A much higher intensity for the PET signal can be obtained using β+-radioactive beams directly for treatment. This idea has always been hampered by the low intensity of the secondary beams, produced by fragmentation of the primary, stable beams. With the intensity upgrade of the SIS-18 synchrotron and the isotopic separation with the fragment separator FRS in the FAIR-phase-0 in Darmstadt, it is now possible to reach radioactive ion beams with sufficient intensity to treat a tumor in small animals. This was the motivation of the BARB (Biomedical Applications of Radioactive ion Beams) experiment that is ongoing at GSI in Darmstadt. This paper will present the plans and instruments developed by the BARB collaboration for testing the use of radioactive beams in cancer therapy.

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Section: Radiobiologymentioning

confidence: 99%

Radioactive Beams for Image-Guided Particle Therapy: The BARB Experiment at GSI

Boscolo¹,

Kostyleva²,

Safari³

et al. 2021

Front. Oncol.

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“…Notably, retrospective studies from the Memorial Sloan Kettering Cancer Center of single-fraction SRS for metastatic disease to the spine have demonstrated excellent local control with minimal high-grade toxicity, irrespective of histology [ 22 , 23 ]. Furthermore, a recently published Phase III trial of single-fraction SRS vs. three-fraction SBRT for oligometastatic disease (including 10% lung cancer patients) showed superior local control and a decreased incidence of distant metastatic progression with single-fraction SRS [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Results of Radiation Therapy as Local Ablative Therapy for Oligometastatic Non-Small Cell Lung Cancer

Billing

Rimner

2021

Cancers

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Oligometastatic cancer is characterized by a limited number of metastatic deposits. Compared with lung cancer patients who have more widespread disease, oligometastatic lung cancer patients have more favorable survival outcomes. Therefore, it has been hypothesized that local ablative therapy (LAT) directed at the metastatic deposits in addition to standard-of-care systemic therapy may further improve survival outcomes in oligometastatic lung cancer patients. One LAT modality that has been utilized in oligometastatic lung cancer is radiation therapy. In particular, ultra-hypofractionated radiotherapy, also known as stereotactic body radiotherapy (SBRT), has been shown to provide excellent local control with a favorable safety profile. Here, we reviewed the retrospective studies and prospective trials that have deployed radiation therapy as LAT in oligometastatic lung cancer, including randomized studies showing benefits for progression-free survival and overall survival with the addition of LAT. We also discuss the impact of targeted therapies and immunotherapy on radiation as LAT.

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“…Compared with a leukaemia-like dissemination of many malignant processes, the encouraging aspect of a spatially limited oligometastatic disease has ignited a steep rise of scientific interest with new research questions and challenges. We have divided them in three main categories, summarized in Table 1 [ 2 , 3 , 4 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ]. One of the major drawbacks of the oligometastatic concept is the current perception relying on therapeutic opportunity and cross-sectional imaging rather than intra- and intercellular processes [ 7 ].…”

mentioning

confidence: 99%

“…Despite these controversies and information gaps, local approaches should be praised for their cost-effectiveness, compliance, and low toxicity [ 21 , 24 , 30 ]. Moreover, oligometastases provide a new and exciting area of scientific opportunities.…”

mentioning

confidence: 99%