Stereotactic Radiosurgery and Stereotactic Body Radiotherapy in the Management of Oligometastatic Disease

被引:38
作者
Chen, H. [1 ]
Louie, A., V [1 ]
Higginson, D. S. [2 ]
Palma, D. A. [3 ]
Colaco, R. [4 ]
Sahgal, A. [1 ]
机构
[1] Sunnybrook Odette Canc Ctr, Dept Radiat Oncol, Toronto, ON, Canada
[2] Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, 1275 York Ave, New York, NY 10021 USA
[3] London Hlth Sci Ctr, Dept Radiat Oncol, London, ON, Canada
[4] Christie NHS Fdn Trust, Dept Clin Oncol, Manchester, Lancs, England
关键词
Oligometastasis; Stereotactic ablative radiotherapy; Stereotactic body radiotherapy; Stereotactic radiosurgery; WHOLE-BRAIN RADIOTHERAPY; CELL LUNG-CANCER; RADIATION-THERAPY; SURGICAL RESECTION; LIVER METASTASES; MULTICENTER; TRIAL; RECURRENCE; BIOLOGY; RISK;
D O I
10.1016/j.clon.2020.06.018
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Stereotactic radiosurgery (SRS) and stereotactic body radiotherapy (SBRT) represent non-invasive, efficacious and safe radiation treatments for the ablation of intracranial and extracranial metastases. Although the use of SRS has been established by level 1 evidence for patients presenting with up to three or four brain metastases for at least a decade, the paradigm of ablating a limited number of extracranial metastases (typically up to five, known as oligometastatic disease) has yet to be proven beyond the few reported but highly encouraging phase II randomised trials. In this overview, we summarise the phase III randomised controlled trials evaluating SRS for intact brain metastases and postoperative surgical cavities and introduce the limited literature and future concepts for treating patients with more than five intracranial metastases. Next, we summarise the published phase II randomised controlled trials specific to SBRT and oligometastatic disease, while briefly describing and contrasting the technical principles and biological mechanisms of SBRT versus conventional radiation. Phase III evidence for SBRT is needed, and we summarise ongoing trials in this overview. Ultimately, SRS and SBRT have become cornerstone therapeutic options for patients with oligometastatic disease and the future is bright for these patients, considering that not so long ago they were considered incurable and relegated to palliation alone. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:713 / 727
页数:15
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