Should organs at risk (OARs) be prioritized over target volume coverage in stereotactic ablative radiotherapy (SABR) for oligometastases? a secondary analysis of the population-based phase II SABR-5 trial

被引：18

作者：

Cereno, Reno Eufemon ^{[1
,2
]}

Mou, Benjamin ^{[1
,2
]}

Baker, Sarah ^{[1
,3
]}

Chng, Nick ^{[4
]}

Arbour, Gregory ^{[1
]}

Bergman, Alanah ^{[1
,5
]}

Liu, Mitchell ^{[1
,5
]}

Schellenberg, Devin ^{[1
,3
]}

Matthews, Quinn ^{[4
]}

Huang, Vicky ^{[3
]}

Mestrovic, Ante ^{[6
]}

Hyde, Derek ^{[2
]}

Alexander, Abraham ^{[1
,6
]}

Carolan, Hannah ^{[1
,5
]}

Hsu, Fred ^{[1
,7
]}

Miller, Stacy ^{[1
,4
]}

Atrchian, Siavash ^{[1
,2
]}

Chan, Elisa ^{[1
,5
]}

Ho, Clement ^{[1
,3
]}

Mohamed, Islam ^{[1
,2
]}

Lin, Angela ^{[1
,2
]}

Berrang, Tanya ^{[1
,6
]}

Bang, Andrew ^{[1
,5
]}

Jiang, Will ^{[1
,4
]}

Lund, Chad ^{[1
,3
]}

Pai, Howard ^{[1
,6
]}

Valev, Boris ^{[6
]}

Lefresne, Shilo ^{[5
]}

Tyldesley, Scott ^{[5
]}

Olson, Robert A. ^{[1
,4
,8
]}

机构：

[1] Univ British Columbia, Vancouver, BC, Canada

[2] British Columbia Canc, Kelowna, BC, Canada

[3] British Columbia Canc, Surrey, BC, Canada

[4] British Columbia Canc, Prince George, BC, Canada

[5] British Columbia Canc, Vancouver, BC, Canada

[6] British Columbia Canc, Victoria, BC, Canada

[7] British Columbia Canc, Abbotsford, BC, Canada

[8] BC Canc Prince George, 1215 Lethbridge St, Prince George, BC V2M 7E9, Canada

来源：

RADIOTHERAPY AND ONCOLOGY | 2023年 / 182卷

关键词：

Oligometastasis; Oligometastases; Stereotactic ablative radiotherapy; Stereotactic body radiation therapy; SABR; SABR-5; SBRT; Coverage compromise index; CELL LUNG-CANCER; LOCAL TUMOR-CONTROL; PULMONARY OLIGOMETASTASES; PREDICTORS; THERAPY; DISEASE;

D O I：

10.1016/j.radonc.2023.109576

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background and Purpose: Stereotactic ablative radiotherapy (SABR) for oligometastases may improve survival, however concerns about safety remain. To mitigate risk of toxicity, target coverage was sacrificed to prioritize organs-at-risk (OARs) during SABR planning in the population-based SABR-5 trial. This study evaluated the effect of this practice on dosimetry, local recurrence (LR), and progression-free survival (PFS). Methods: This single-arm phase II trial included patients with up to 5 oligometastases between November 2016 and July 2020. The protocol-specified planning objective was to cover 95 % of the planning target volume (PTV) with 100 % of the prescribed dose, however PTV coverage was reduced as needed to meet OAR constraints. This trade-off was measured using the coverage compromise index (CCI), computed as minimum dose received by the hottest 99 % of the PTV (D99) divided by the prescription dose. Under-coverage was defined as CCI < 0.90. The potential association between CCI and outcomes was evaluated. Results: 549 lesions from 381 patients were assessed. Mean CCI was 0.88 (95 % confidence interval [CI], 0.86-0.89), and 196 (36 %) lesions were under-covered. The highest mean CCI (0.95; 95 %CI, 0.93-0.97) was in non-spine bone lesions (n = 116), while the lowest mean CCI (0.71; 95 % CI, 0.69-0.73) was in spine lesions (n = 104). On multivariable analysis, under-coverage did not predict for worse LR (HR 0.48, p = 0.37) or PFS (HR 1.24, p = 0.38). Largest lesion diameter, colorectal and 'other' (non-prostate, breast, or lung) primary predicted for worse LR. Largest lesion diameter, synchronous tumor treatment, short disease free interval, state of oligoprogression, initiation or change in systemic treatment, and a high PTV Dmax were significantly associated with PFS. Conclusion: PTV under-coverage was not associated with worse LR or PFS in this large, population-based phase II trial. Combined with low toxicity rates, this study supports the practice of prioritizing OAR constraints during oligometastatic SABR planning. (c) 2023 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 183 (2023) 1-8

引用

页数：8

共 27 条

[1]

[Anonymous], 2021, ACTA ONCOL MADR, V60, P505, DOI [10.1080/ 0284186X.2021.1874617, DOI 10.1080/0284186X.2021.1874617]

[2] Predictors of Early Polymetastatic Relapse After SABR for up to 5 Oligometastases: A Secondary Analysis of the Phase II SABR-5 Trial [J].

Baker, Sarah ;

Mou, Benjamin ;

Jiang, Will ;

Liu, Mitchell ;

Bergman, Alanah M. ;

Schellenberg, Devin ;

Alexander, Abraham S. ;

Carolan, Hannah ;

Atrchian, Siavash ;

Berrang, Tanya ;

Bang, Andrew ;

Chng, Nick ;

Matthews, Quinn ;

Tyldesley, Scott ;

Olson, Robert A. .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2022, 114 (05) :856-861

[3] Progression-Free Survival and Local Control After SABR for up to 5 Oligometastases: An Analysis From the Population-Based Phase 2 SABR-5 Trial [J].

Baker, Sarah ;

Jiang, Will ;

Mou, Benjamin ;

Lund, Chad R. ;

Liu, Mitchell ;

Bergman, Alanah M. ;

Schellenberg, Devin ;

Alexander, Abraham S. ;

Carolan, Hannah ;

Atrchian, Siavash ;

Chng, Nick ;

Matthews, Quinn ;

Arbour, Gregory ;

Benny, Alexander ;

Tyldesley, Scott ;

Olson, Robert A. .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2022, 114 (04) :617-626

[4]

Cereno RE, 2022, J RADIOSURGERY SBRT

[5] Can dose outside the PTV influence the risk of distant metastases in stage I lung cancer patients treated with stereotactic body radiotherapy (SBRT)? [J].

Diamant, Andre ;

Chatterjee, Avishek ;

Faria, Sergio ;

El Naqa, Issam ;

Bahig, Houda ;

Filion, Edith ;

Robinson, Cliff ;

Al-Halabi, Hani ;

Seuntjens, Jan .

RADIOTHERAPY AND ONCOLOGY, 2018, 128 (03) :513-519

[6] Prognostic factors of local control and disease free survival in centrally located non-small cell lung cancer treated with stereotactic body radiation therapy [J].

Duijm, Marloes ;

van der Voort van Zyp, Noelle C. ;

Granton, Patrick V. ;

van de Vaart, Paul ;

Mast, Mirjam E. ;

Oomen-de Hoop, Esther ;

Hoogeman, Mischa S. ;

Nuyttens, Joost J. .

ACTA ONCOLOGICA, 2020, 59 (07) :809-817

[7] Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non-small-cell lung cancer without progression after first-line systemic therapy: a multicentre, randomised, controlled, phase 2 study [J].

Gomez, Daniel R. ;

Blumenschein, George R., Jr. ;

Lee, J. Jack ;

Hernandez, Mike ;

Ye, Rong ;

Camidge, D. Ross ;

Doebele, Robert C. ;

Skoulidis, Ferdinandos ;

Gaspar, Laurie E. ;

Gibbons, Don L. ;

Karam, Jose A. ;

Kavanagh, Brian D. ;

Tang, Chad ;

Komaki, Ritsuko ;

Louie, Alexander V. ;

Palma, David A. ;

Tsao, Anne S. ;

Sepesi, Boris ;

William, William N. ;

Zhang, Jianjun ;

Shi, Qiuling ;

Wang, Xin Shelley ;

Swisher, Stephen G. ;

Heymach, John V. .

LANCET ONCOLOGY, 2016, 17 (12) :1672-1682

[8] Local tumor control probability modeling of primary and secondary lung tumors in stereotactic body radiotherapy [J].

Guckenberger, Matthias ;

Klement, Rainer J. ;

Allgaeuer, Michael ;

Andratschke, Nicolaus ;

Blanck, Oliver ;

Boda-Heggemann, Judit ;

Dieckmann, Karin ;

Duma, Marciana ;

Ernst, Iris ;

Ganswindt, Ute ;

Hass, Peter ;

Henkenberens, Christoph ;

Holy, Richard ;

Imhoff, Detlef ;

Kahl, Henning K. ;

Krempien, Robert ;

Lohaus, Fabian ;

Nestle, Ursula ;

Nevinny-Stickel, Meinhard ;

Petersen, Cordula ;

Semrau, Sabine ;

Streblow, Jan ;

Wendt, Thomas G. ;

Wittig, Andrea ;

Flentje, Michael ;

Sterzing, Florian .

RADIOTHERAPY AND ONCOLOGY, 2016, 118 (03) :485-491

[9] Stereotactic Radiation for the Comprehensive Treatment of Oligometastases (SABR-COMET): Extended Long-Term Outcomes [J].

Harrow, Stephen ;

Palma, David A. ;

Olson, Robert ;

Gaede, Stewart ;

V. Louie, Alexander ;

Haasbeek, Cornelis ;

Mulroy, Liam ;

Lock, Michael ;

Rodrigues, George B. ;

Yaremko, Brian P. ;

Schellenberg, Devin ;

Ahmad, Belal ;

Senthi, Sashendra ;

Swaminath, Anand ;

Kopek, Neil ;

Liu, Mitchell ;

Schlijper, Roel ;

Bauman, Glenn S. ;

Laba, Joanna ;

Qu, X. Melody ;

Warner, Andrew ;

Senan, Suresh .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2022, 114 (04) :611-616

[10] Stereotactic body radiotherapy for oligo-metastatic liver disease - Influence of pre-treatment chemotherapy and histology on local tumor control [J].

Klement, R. J. ;

Guckenberger, M. ;

Alheid, H. ;

Allgaeuer, M. ;

Becker, G. ;

Blanck, O. ;

Boda-Heggemann, J. ;

Brunner, T. ;

Duma, M. ;

Gerum, S. ;

Habermehl, D. ;

Hildebrandt, G. ;

Lewitzki, V. ;

Ostheimer, C. ;

Papachristofilou, A. ;

Petersen, C. ;

Schneider, T. ;

Semrau, R. ;

Wachter, S. ;

Andratschke, N. .

RADIOTHERAPY AND ONCOLOGY, 2017, 123 (02) :227-233

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