Long-term Follow-up and Patterns of Recurrence of Patients With Oligometastatic NSCLC Treated With Pulmonary SBRT

被引：40

作者：

Hoerner-Rieber, Juliane ^{[1
,2
,3
,4
]}

Bernhardt, Denise ^{[1
,2
,3
]}

Blanck, Oliver ^{[5
]}

Duma, Marciana ^{[6
]}

Eich, Hans Th ^{[7
]}

Gerum, Sabine ^{[8
]}

Gkika, Eleni ^{[9
]}

Hass, Peter ^{[10
]}

Henkenberens, Christoph ^{[11
]}

Herold, Hans-Ulrich ^{[12
]}

Hildebrandt, Guido ^{[13
]}

Imhoff, Detlef ^{[14
]}

Kahl, Henning ^{[15
]}

Janssen, Stefan ^{[16
,17
]}

Jurianz, Katrin ^{[18
]}

Krempien, Robert ^{[19
]}

Lautenschlaeger, Stefan Friedrich ^{[20
]}

Lohaus, Fabian ^{[21
,22
,23
,24
,25
,26
]}

Mueller, Arndt-Christian ^{[27
,28
]}

Petersen, Cordula ^{[29
]}

Sackerer, Irina ^{[30
]}

Scafa, Davide ^{[31
]}

Schrade, Elsge ^{[32
]}

Uhlmann, Lorenz ^{[33
]}

Wittig, Andrea ^{[34
]}

Guckenberger, Matthias ^{[35
]}

机构：

[1] Univ Hosp Heidelberg, Dept Radiat Oncol, INF 400, D-69120 Heidelberg, Germany

[2] Heidelberg Inst Radiat Oncol, Heidelberg, Germany

[3] Natl Ctr Tumor Dis NCT, Heidelberg, Germany

[4] German Canc Res Ctr, Clin Cooperat Unit Radiat Oncol, Heidelberg, Germany

[5] UKSH, Dept Radiat Oncol, Kiel, Germany

[6] Tech Univ Munich, Dept Radiat Oncol, Klinikum Rechts Isar, Munich, Germany

[7] Univ Munster, Dept Radiat Oncol, Munster, Germany

[8] LMU Ludwig Maximilians Univ Munich, Dept Radiat Oncol, Munich, Germany

[9] Univ Med Ctr Freiburg, Dept Radiat Oncol, Freiburg, Germany

[10] Univ Hosp Magdeburg, Dept Radiat Oncol, Magdeburg, Germany

[11] Med Sch Hannover, Dept Radiotherapy & Special Oncol, Hannover, Germany

[12] CyberKnife Ctr Erfurt, Erfurt, Germany

[13] Univ Rostock, Dept Radiat Oncol, Rostock, Germany

[14] Univ Hosp Frankfurt, Dept Radiat Oncol, Frankfurt, Germany

[15] Hosp Augsburg, Dept Radiat Oncol, Augsburg, Germany

[16] Med Practice Radiotherapy & Radiat Oncol, Hannover, Germany

[17] Univ Lubeck, Dept Radiat Oncol, Lubeck, Germany

[18] Gamma Knife Ctr Krefeld, Krefeld, Germany

[19] Helios Klinikum Berlin Buch, Dept Radiat Oncol, Berlin, Germany

[20] Philipps Univ Marburg, Univ Hosp Giessen & Marburg, Dept Radiotherapy & Radiat Oncol, Marburg, Germany

[21] Tech Univ Dresden, Med Fac, Dept Radiat Oncol, Dresden, Germany

[22] Tech Univ Dresden, Univ Hosp CG Carus, Dresden, Germany

[23] German Canc Res Ctr, Heidelberg, Germany

[24] German Canc Consortium DKTK, Partner Site Dresden, Dresden, Germany

[25] Tech Univ Dresden, Fac Med, OncoRay Natl Ctr Radiat Res Oncol, Dresden, Germany

[26] Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dresden, Germany

[27] Eberhard Karls Univ Tuebingen, Univ Hosp, Dept Radiat Oncol, Tubingen, Germany

[28] Eberhard Karls Univ Tuebingen, Med Fac, Tubingen, Germany

[29] Univ Hosp Hamburg Eppendorf, Dept Radiat Oncol, Hamburg, Germany

[30] Radiat Oncol, Freising Weihenstephan, Germany

[31] Heidelberg Univ, Univ Med Ctr Mannheim, Dept Radiat Oncol, Mannheim, Germany

[32] Hosp Heidenhe, Dept Radiat Oncol, Heidenheim, Germany

[33] Heidelberg Univ, Inst Med Biometry & Informat, Heidelberg, Germany

[34] Univ Hosp Jena, Dept Radiotherapy & Radiat Oncol, Jena, Germany

[35] Univ Zurich, Univ Hosp Zurich, Dept Radiat Oncol, Zurich, Switzerland

来源：

CLINICAL LUNG CANCER | 2019年 / 20卷 / 06期

关键词：

Local therapy; Nonesmall-cell lung cancer (NSCLC); Oligometastases; Patterns of recurrence; Stereotactic body radiotherapy; CELL LUNG-CANCER; BODY RADIATION-THERAPY; LOCAL CONSOLIDATIVE THERAPY; PHASE-II; RADIOTHERAPY; MAINTENANCE; OUTCOMES; CHEMOTHERAPY; MULTICENTER; PROGRESSION;

D O I：

10.1016/j.cllc.2019.06.024

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

This multicenter analysis included 301 patients with oligometastatic non-small-cell lung cancer treated with pulmonary stereotactic body radiotherapy for 336 lung metastases. In routine clinical practice, stereotactic body radiotherapy for pulmonary oligometastatic non-small-cell lung cancer achieved favorable local control and promising overall survival. The dominant failure pattern was distant with a continuously high risk of disease progression for many years. Prospective studies should therefore combine local therapy with novel systemic treatments. Introduction: This multicenter study aims to analyze outcome as well as early versus late patterns of recurrence following pulmonary stereotactic body radiotherapy (SBRT) for patients with oligometastatic non-small-cell lung cancer (NSCLC). Materials and Methods: This analysis included 301 patients with oligometastatic NSCLC treated with SBRT for 336 lung metastases. Although treatment of the primary tumor consisted of surgical resection, radiochemotherapy, and/or systemic therapy, pulmonary oligometastases were treated with SBRT. Results: The median follow-up time was 16.1 months, resulting in 2-year overall survival (OS), local control (LC), and distant control (DC) of 62.2%, 82.0%, and 45.2%, respectively. Multivariate analysis identified age (P = .019) and histologic subtype (P = .028), as well as number of metastatic organs (P < .001) as independent prognostic factors for OS. LC was superior for patients with favorable histologic subtype (P = .046) and SBRT with a higher biological effective dose at isocenter (P = .037), whereas DC was inferior for patients with metastases in multiple organs (P < .001) and female gender (P = .027). Early (within 24 months) local or distant progression was observed in 15.3% and 36.5% of the patients. After 24 months, the risk of late local failure was low, with 3- and 4-year local failure rates of only 4.0%, and 7.6%. In contrast, patients remained at a high risk of distant progression with 3- and 4-year failure rates of 13.3% and 24.1%, respectively, with no plateau observed. Conclusion: SBRT for pulmonary oligometastatic NSCLC resulted in favorable LC and promising OS. The dominant failure pattern is distant with a continuously high risk of disease progression for many years.

引用

页码：E667 / E677

页数：11

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