Stereotactic Body Radiation Therapy for Oligoprogressive Ovarian Cancer Patients Treated During Poly(ADP-Ribose)-Polymerase Inhibitor Maintenance: Efficacy and Adverse Events From the Epimetheo Retrospective Study.

Autor: Macchia G; Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Molise, Italy. Electronic address: macchiagabriella@gmail.com., Pezzulla D; Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Molise, Italy., Campitelli M; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Russo D; Radiotherapy Unit, Ospedale 'Vito Fazzi', Lecce, Italy., Ronzino G; Medical Oncology Unit, Ospedale 'Vito Fazzi', Lecce, Italy., Lucci S; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Salutari V; UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Di Stefano A; Medical Oncology Unit, Responsible Research Hospital, Campobasso, Molise, Italy., Balcet V; UOC Radioterapia, Nuovo Ospedale degli Infermi, Biella, Italy., Epifani V; Department of Medicine and Surgery, Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy., Perrucci E; Department of Medicine and Surgery, Radiation Oncology Section, University of Perugia and Perugia General Hospital, Perugia, Italy., Marchetti C; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Distefano MG; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Palluzzi E; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Autorino R; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., De Luca V; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Giannini R; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Rinaldi R; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Russo SA; UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia., Cilla S; Medical Physics Unit, Responsible Research Hospital, Campobasso, Molise, Italy., Fagotti A; UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia; Dipartimento Universitario di Scienze della Vita e Sanità pubblica, Sezione di Ginecologia ed Ostetricia, Università Cattolica del Sacro Cuore, Roma, Italia., Gambacorta MA; UOC di Radioterapia, Dipartimento di Scienze Radiologiche, Radioterapiche ed Ematologiche, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia., Scambia G; UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia; Dipartimento Universitario di Scienze della Vita e Sanità pubblica, Sezione di Ginecologia ed Ostetricia, Università Cattolica del Sacro Cuore, Roma, Italia., Deodato F; Radiation Oncology Unit, Responsible Research Hospital, Campobasso, Molise, Italy; Istituto di Radiologia, Università Cattolica del Sacro Cuore, Roma, Italia., Ferrandina G; UOC Ginecologia Oncologica, Dipartimento per la Salute della Donna e del Bambino e della Salute Pubblica, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italia; Dipartimento Universitario di Scienze della Vita e Sanità pubblica, Sezione di Ginecologia ed Ostetricia, Università Cattolica del Sacro Cuore, Roma, Italia.
Jazyk: angličtina
Zdroj: International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2024 Sep 08. Date of Electronic Publication: 2024 Sep 08.
DOI: 10.1016/j.ijrobp.2024.09.010
Abstrakt: Purpose: The aim of this observational, retrospective, multicenter study (Epimetheo) was to analyze the activity and the safety of stereotactic body radiation therapy (SBRT) during poly(ADP-ribose)-polymerase inhibitor (PARPi) maintenance in a series of oligometastatic ovarian cancer (OC) patients.
Methods and Materials: Patients treated with PARPi in maintenance setting received SBRT if oligometastatic progression occurred. Maintenance treatment was continued until the extensive progression of the disease. The primary endpoints of the study were as follows: next systemic treatment change-free survival (NEST-FS) and acute and late toxicity; the secondary endpoints were as follows: the rate of clinical complete response (CR), the 2-year actuarial local control (LC, progression of disease inside SBRT field) rate on "per lesion" basis, the 2-year actuarial progression-free survival, and 2-year overall survival (OS).
Results: From April 2018 to September 2023, SBRT was used to treat 74 OC patients with a total of 158 lesions (98 lymph nodes and 60 parenchymal lesions) under PARPi maintenance. Olaparib, niraparib, and rucaparib were administered to 41.9%, 48.6%, and 9.5% of patients, respectively. CR, partial response, stable disease, and progressive disease were observed in 115 (72.8%), 32 (20.3%), 9 (5.7%), and 2 lesions (1.3%), respectively. Severe toxicities were reported in less than 3% of patients. The actuarial median NEST-FS was 10 months, with a range of 6.7-13.3 months. The 12- and 24-month actuarial NEST-FS rates were 44.9% and 31.4%, respectively. The 2-year actuarial LC, progression-free survival, and OS were 68.1%, 22.5%, and 77%, respectively with differences in figures between complete and incomplete responders. The achievement of CR was found to be correlated with an improvement in LC and OS.
Conclusions: This study reports the activity and the low toxicity profile of SBRT in association with PARPi in oligometastatic OC patients. A rapid, minimally invasive, and cost-effective treatment such as SBRT may be proposed as a means of prolonging NEST-FS and maintaining an effective treatment regimen involving PARPi.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE