Stereotactic body radiotherapy to defer systemic therapy in patients with oligorecurrent disease

Willmann, Jonas; Badra, Eugenia Vlaskou; Adilovic, Selma; Christ, Sebastian M.; Ahmadsei, Maiwand; Mayinger, Michael; Gückenberger, Matthias; Andratschke, Nicolaus

doi:10.1016/j.ctro.2022.08.008

Cited by 6 publications

(3 citation statements)

References 27 publications

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“…In oligometastatic settings, the achievement of high ORR has proved to be a pivotal goal of any locoregional treatment, including RT [24] , allowing in the case of ovarian cancer to raise a “drug-free holiday”, crucial in the chronicization of the disease. In this “ PARP-I era ”, all efforts should be made to avoid a rechallenge with cytotoxic platinum-based chemotherapy, considering that platinum-sensitive MPR ovarian cancers are eligible for PARP-I [25] .…”

Section: Discussionmentioning

confidence: 99%

The first real-world study on the role of carbon ion radiotherapy for oligo-metastatic, persistent, or recurrent (MPR) ovarian/fallopian tube cancer

Barcellini,

Murata,

Fontana

et al. 2024

Clinical and Translational Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

The first real-world study on the role of carbon ion radiotherapy for oligo-metastatic, persistent, or recurrent (MPR) ovarian/fallopian tube cancer

Barcellini,

Murata,

Fontana

et al. 2024

Clinical and Translational Radiation Oncology

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“…Other non-surgical approaches have also been utilized. Stereotactic body radiotherapy has shown activity for RCC and can be a well-tolerated localized therapy to combine with systemic therapy [24][25][26]. Radiofrequency ablation (RFA) is another less invasive technique that employs high-frequency electrical current to destroy tumor tissue and can offer shorter recovery times compared to surgery [27].…”

Section: Discussionmentioning

confidence: 99%

Management of Renal Cell Carcinoma With Supradiaphragmatic Inferior Vena Cava Thrombus Diagnosed During Acute COVID-19 Infection

Leyderman,

McElree,

Nepple

et al. 2024

Cureus

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Renal cell carcinoma (RCC) tends to undergo intravascular tumor growth along the renal vein, forming tumor thrombi that may extend into the inferior vena cava (IVC) or even the right atrium (Level IV). Managing such cases requires a multidisciplinary approach, especially in patients with acute coronavirus disease 2019 (COVID-19) infection, who face increased risks from surgical interventions. We present a case of RCC with Level IV thrombus and concurrent COVID-19 managed with systemic therapy. We also summarize current literature on treating RCC with IVC thrombus and COVID-19's impact on prognosis. The patient was a 70-year-old female with incidental detection of a 9-cm right heterogeneous renal mass with a supradiaphragmatic tumor thrombus during COVID-19 infection. Due to ongoing pulmonary symptoms, systemic therapy with a combination of ipilimumab and nivolumab was initiated. After an excellent initial response, the patient continued systemic therapy, maintaining a necrotic response in the renal mass and tumor thrombus. The patient continues to tolerate systemic therapy well. We report a rare case of RCC with Level IV tumor thrombus and synchronous acute COVID-19 infection. Our report depicts successful management utilizing systemic therapy with a combination of ipilimumab and nivolumab. The management of such cases necessitates a comprehensive, multidisciplinary approach, considering the risks associated with surgery in the context of recent COVID-19 infection. The case presentation and ensuing literature discussion of the dynamic landscape of RCC management highlights the need for more research to improve treatment plans and guide clinicians in handling such complex situations.

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“…Also, different prospective studies showed improved survival outcomes by treating OMD with stereotactic radiotherapy [ 12 , 13 ]. Besides the efficacy of stereotactic radiotherapy as a metastasis-directed therapy, it may defer the systemic treatment for selected patients, reducing the potential side effects resulting from these therapies [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Stereotactic radiotherapy in the management of oligometastatic and recurrent head and neck cancer: a single-center experience

Mohamed,

Goncalves,

Singh

et al. 2023

Strahlenther Onkol

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Introduction Oligometastatic disease (OMD) is a metastatic stage that could benefit maximally from local therapies. Patients in this state have a better prognosis relative to those with disseminated metastases. Stereotactic radiotherapy provides a non-invasive ablative tool for primary malignant tumors and metastases. Materials and methods We searched our register for patients with oligometastatic or recurrent head and neck cancer (OMD/R-HNC) who received stereotactic radiotherapy to manage their OMD/R. We evaluated the survival outcomes and prognostic factors that affected the survival of those patients. Results In all, 31 patients with 48 lesions met the inclusion criteria for the analysis. The lesions comprised various metastatic sites, with the majority being pulmonary (37 lesions). Squamous cell cancer was the most common histology (26 patients). The median overall survival (mOS) was 33 months, with a progression-free survival (PFS) of 9.6 months. Eight patients received subsequent stereotactic radiotherapy after disease progression. The local control (LC) rates were 91.3, 87.7, and 83% at 6, 12, and 36 months. Patients with the de novo OMD who received stereotactic radiotherapy as their initial treatment had a median systemic treatment-free survival of 23.9 months. In univariate analysis, a trend for better OS was observed in patients with p16-positive squamous cell tumors; patients who progressed within 150 days after diagnosis had a significantly lower OS. De novo OMD showed significantly better PFS compared to induced OMD. Multivariate analyses identified p16-positive squamous cell cancer, metachronous OMD and a longer time to progression as positive predictors of OS, while de novo OMD was the only positive predictor for PFS. Treatment-related toxicities were generally mild, with two cases of grade 3 dysphagia reported. Conclusion Stereotactic radiotherapy demonstrated favorable outcomes in patients with OMD/R-HNC with limited toxicities. Further studies are warranted to validate these findings and optimize treatment strategies for this patient population.

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Stereotactic body radiotherapy to defer systemic therapy in patients with oligorecurrent disease

Cited by 6 publications

References 27 publications

The first real-world study on the role of carbon ion radiotherapy for oligo-metastatic, persistent, or recurrent (MPR) ovarian/fallopian tube cancer

The first real-world study on the role of carbon ion radiotherapy for oligo-metastatic, persistent, or recurrent (MPR) ovarian/fallopian tube cancer

Management of Renal Cell Carcinoma With Supradiaphragmatic Inferior Vena Cava Thrombus Diagnosed During Acute COVID-19 Infection

Stereotactic radiotherapy in the management of oligometastatic and recurrent head and neck cancer: a single-center experience

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