Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastatic Cancers: Long-Term Results of the SABR-COMET Randomized Trial

Palma, David A.; Olson, Robert; Harrow, Stephen; Gaede, Stewart; Louie, A.V.; Haasbeek, Cornelis J.A.; Mulroy, Liam; Lock, Michael; Rodrigues, George; Yaremko, Brian; Schellenberg, Devin; Ahmad, Belal; Senthi, Sashendra; Swaminath, Anand; Kopek, Neil; Liu, M.C.; Moore, Karen; Currie, S.; Schlijper, Roel; Laba, Joanna; Qu, Melody; Warner, Andrew; Senan, Suresh

doi:10.1016/j.ijrobp.2020.07.2251

Cited by 7 publications

(5 citation statements)

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“…SBRT in this setting may provide significant benefit. This is different rationale to potentially pursue SBRT than the oligometastatic disease paradigm (SABR-COMET et) that local ablation to all sites may improve outcomes (26,27). As has been observed recently, radiating a single site in oligometastatic disease is unlikely to provide benefit in patients (28).…”

Section: Discussionmentioning

confidence: 99%

Clinical Effects of Stereotactic Body Radiation Therapy Targeting the Primary Tumor of Liver-Only Oligometastatic Pancreatic Cancer

Zhao

et al. 2021

Front. Oncol.

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AimTo investigate the efficacy and safety of stereotactic body radiotherapy (SBRT) targeting the primary tumor for liver-only oligometastatic pancreatic cancer.MethodsWe compared the efficacy and safety of SBRT plus chemotherapy with chemotherapy alone in patients with liver-only oligometastatic pancreatic cancer. The populations were balanced by propensity score-weighted and propensity score-matched analyses based on baseline variables. The primary outcome was overall survival (OS). The secondary outcomes included progression free survival (PFS), local progression, metastatic progression and symptomatic local control.ResultsThis is a retrospective study of 89 pancreatic cancer patients with liver-only oligometastasis. Overall, 34 (38.2%) and 55 (61.8%) patients received SBRT plus chemotherapy and chemotherapy alone, respectively. After propensity score matching, 1-year OS rate was 34.0% (95%CI, 17.8-65.1%) in the SBRT plus chemotherapy group and 16.5% (95%CI, 5.9-46.1%) in chemotherapy alone group (P=0.115). The 6-month PFS rate was 29.4% (95%CI, 15.4-56.1) in SBRT plus chemotherapy and 20.6% (95%CI, 8.8-48.6) in chemotherapy alone group (P=0.468), respectively. Further subgroup analysis indicated that the addition of SBRT improved OS in patients with primary tumor located in the head of pancreas (stratified HR, 0.28; 95% CI, 0.09 to 0.90) or good performance status (stratified HR, 0.24; 95% CI, 0.07 to 0.86). In terms of disease control, SBRT delayed local progression of pancreas (P=0.008), but not distant metastatic progression (P=0.56). Besides, SBRT offered significant abdominal/back pain relief (P=0.016) with acceptable toxicities.ConclusionsThe addition of SBRT to chemotherapy in patients with liver-only oligometastatic pancreatic cancer improves the OS of those with primary tumor located in the head of pancreas or good performance status. In addition, it is a safe and effective method for local progression control and local symptomatic palliation in patients with metastatic pancreatic cancer.

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Section: Discussionmentioning

confidence: 99%

Clinical Effects of Stereotactic Body Radiation Therapy Targeting the Primary Tumor of Liver-Only Oligometastatic Pancreatic Cancer

Zhao

et al. 2021

Front. Oncol.

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“…Bei oligometastasierten Patienten konnte in randomisierten Studien ein verbessertes Gesamtüberleben sowie verbessertes progressionsfreies Überleben erzielt werden, wenn die leitliniengerech-teSystemtherapieum eine definitivelokale Therapie aller Metastasen ergänzt wurde. Die stereotaktische Bestrahlung wurde bei solchen oligometastasierten Patienten am häufigsten als lokale Therapiemodalität eingesetzt, da sie als nichtinvasive ambulante Therapie die gleichzeitige Therapie von Metastasen in verschiedenen Organsystemen parallel zur Systemtherapie erlaubt [20][21][22]. Auch bei Wirbelsäulenmetastasen sowie Metastasen in den langen Röhrenknochen ist eine fraktionierte körperstereotaktische Bestrahlung sicher anwendbar, ohne erhöhte Risiken für postradiogene pathologische Frakturen, erzielt werden dabei hohe und dauerhafte lokale Tumorkontrollraten von 80-90 % ([1, 23]; .…”

Section: Lebenserwartung Sollte Fraktioniert Bestrahlt Werdenunclassified

Aktuelle interdisziplinäre Behandlung von Knochenmetastasen

et al. 2023

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ZusammenfassungEine Vielzahl an Krebspatienten entwickelt im Verlauf Knochenmetastasen. Die daraus folgenden Symptome wie Schmerzen, Funktionsverlust sowie neurologische Symptome können rasch zu einem onkologischen oder auch chirurgischen Notfall werden, es besteht in vielen Fällen rascher Handlungsbedarf. Ziel dieser Arbeit ist die Darstellung der aktuellen, evidenzbasierten interdisziplinären Behandlung von Knochenmetastasen. Grundsätzlich ist die interdisziplinäre Zusammenarbeit und die Abstimmung aller Disziplinen der Goldstandard zur optimalen Behandlung ossärer Metastasen.

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“…9 High radiation doses were delivered in a majority of patients in this report, 7 an approach that appear to be favored due to survival gains observed with use of SBRT in patients with oligometastatic disease. 10 In addition, durable intrathoracic disease control using SBRT can be relevant due to improved 5-year survival rates in some groups of patients treated with ICIs. 11 A cautionary note regarding use of highdose thoracic radiation in patients with advanced NSCLC comes from findings of two studies.…”

Section: Shaverdian Personal Communication)mentioning

confidence: 99%

Stereotactic Ablative Radiotherapy for the Comprehensive Treatment of Oligometastatic Cancers: Long-Term Results of the SABR-COMET Randomized Trial

Cited by 7 publications

References 0 publications

Clinical Effects of Stereotactic Body Radiation Therapy Targeting the Primary Tumor of Liver-Only Oligometastatic Pancreatic Cancer

Clinical Effects of Stereotactic Body Radiation Therapy Targeting the Primary Tumor of Liver-Only Oligometastatic Pancreatic Cancer

Aktuelle interdisziplinäre Behandlung von Knochenmetastasen

Pulmonary toxicity in patients treated with immune checkpoint inhibitors and radiation

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