Stereotactic body radiotherapy in oligometastatic cervical cancer (MITO-RT2/RAD study): a collaboration of MITO, AIRO GYN, and MaNGO groups.

Autor:	Macchia G; Radiation Oncology Unit, Gemelli Molise, Campobasso, Molise, Italy macchiagabriella@gmail.com., Nardangeli A; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Laliscia C; Department of Translational Medicine, Division of Radiation Oncology, University of Pisa, Pisa, Italy., Fodor A; Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy., Draghini L; Radiation Oncology Center, S Maria Hospital, Terni, Italy., Gentile PC; Radiation Oncology Unit, UPMC Hillman Cancer Center San Pietro FBF, Roma, Italy., D'Agostino GR; Department of Radiotherapy, Radiosurgery Humanitas Clinical and Research Hospital IRCSS Rozzano, Milan, Italy., Balcet V; UOC Radioterapia, Nuovo Ospedale degli Infermi, Biella, Italy., Bonome P; Radiation Oncology Unit, Gemelli Molise, Campobasso, Molise, Italy., Ferioli M; Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental, Diagnostic and Specialty Medicine, DIMES, Alma Mater Studiorum, University of Bologna, Bologna, Italy., Autorino R; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Vicenzi L; Radiation Oncology Unit, Azienda Ospedaliera Universitaria Ospedali Riuniti, Ancona, Italy., Raguso A; UOC Radioterapia, Fondazione 'Casa Sollievo della Sofferenza', IRCCS, S. Giovanni Rotondo, Foggia, Italy., Borghesi S; Radiation Oncology Unit of Arezzo-Valdarno, Azienda USL Toscana sud est, Arezzo, Toscana, Italy., Ippolito E; Department of Radiation Oncology, Campus Bio-Medico University, Roma, Italy., Di Cataldo V; Radiation Oncology Unit, Oncology Department, University of Florence, Firenze, Italy., Cilla S; Medical Physics Unit, Gemelli Molise, Campobasso, Molise, Italy., Perrucci E; Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy., Campitelli M; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Gambacorta MA; UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia, Oncologia ed Ematologia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy., Deodato F; Radiation Oncology Unit, Gemelli Molise, Campobasso, Molise, Italy.; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italy., Scambia G; UOC Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy., Ferrandina G; UOC Ginecologia Oncologica, Dipartimento Scienze della Salute della Donna e del Bambino, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.
Jazyk:	angličtina
Zdroj:	International journal of gynecological cancer : official journal of the International Gynecological Cancer Society [Int J Gynecol Cancer] 2022 Jun 06; Vol. 32 (6), pp. 732-739. Date of Electronic Publication: 2022 Jun 06.
DOI:	10.1136/ijgc-2021-003237
Abstrakt:	Objective: This retrospective, multicenter study analyzes the efficacy and safety of stereotactic body radiotherapy in a large cohort of patients with oligometastatic/persistent/recurrent cervical cancer. Methods: A standardized data collection from several radiotherapy centers that treated patients by stereotactic body radiotherapy between March 2006 and February 2021 was set up. Clinical and stereotactic body radiotherapy parameters were collected. Objective response rate was defined as a composite of complete and partial response, while clinical benefit included objective response rate plus stable disease. Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer and Common Terminology Criteria for Adverse Events scales were used to grade toxicities. The primary endpoints were the rate of complete response to stereotactic body radiotherapy, and the 2 year actuarial local control rate on a 'per lesion' basis. The secondary end points were progression-free survival and overall survival, as well as toxicity. Results: A total of 83 patients with oligometastatic/persistent/recurrent cervical cancer bearing 125 lesions treated by stereotactic body radiotherapy at 15 different centers were selected for analysis. Of the sites of metastatic disease, lymph node metastases were most common (55.2%), followed by parenchyma lesions (44.8%). Median total dose was 35 Gy (range 10-60), in five fractions (range 1-10), with a median dose/fraction of 7 Gy (range 4-26). Complete, partial, and stable response were found in 73 (58.4%), 29 (23.2%), and 16 (12.8%) lesions, respectively, reaching 94.4% of the clinical benefit rate. Forty-six (55.4%) patients had a complete response. Patients achieving complete response on a 'per lesion' basis experienced a 2 year actuarial local control rate of 89.0% versus 22.1% in lesions not achieving complete response (p<0.001). The 2 year actuarial progression-free survival rate was 42.5% in patients with complete response versus 7.8% in patients with partial response or stable or progressive disease (p=0.001). The 2 year actuarial overall survival rate was 68.9% in patients with complete response versus 44.3% in patients with partial response or stable or progressive disease (p=0.015). Fifteen patients (18.1%) had mild acute toxicity, totaling 29 side events. Late toxicity was documented in four patients (4.8%) totaling seven adverse events. Conclusion: Our analysis confirmed the efficacy of stereotactic body radiotherapy in oligometastatic/persistent/recurrent cervical cancer patients. The low toxicity profile encourages the wider use of stereotactic body radiotherapy in this setting. Competing Interests: Competing interests: None declared. (© IGCS and ESGO 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu