Ablative Therapy for Oligometastatic Non-Small Cell Lung Cancer
| Autor: | Sanjay Popat, Oscar Juan |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research Lung Neoplasms medicine.medical_treatment NSCLC law.invention 0302 clinical medicine PROGNOSTIC-FACTORS Randomized controlled trial law Carcinoma Non-Small-Cell Lung Neoplasm Metastasis ISOLATED ADRENAL METASTASIS SBRT Brain Neoplasms Disease Controlled Synchronous Survival Rate 030220 oncology & carcinogenesis SYNCHRONOUS BRAIN METASTASES Disease Progression CLINICAL-PRACTICE GUIDELINES Life Sciences & Biomedicine Oligometastases COMBINED SURGICAL-TREATMENT Pulmonary and Respiratory Medicine medicine.medical_specialty Context (language use) Radiosurgery Disease-Free Survival PHASE I/II TRIAL 03 medical and health sciences Internal medicine RADIATION-THERAPY medicine Humans Oncology & Carcinogenesis Lung cancer Survival rate Science & Technology Radiotherapy business.industry INDIVIDUAL PATIENT DATA Cancer LONG-TERM SURVIVAL STEREOTACTIC BODY RADIOTHERAPY medicine.disease Radiation therapy 030104 developmental biology Surgery business |
| Popis: | The oligometastatic state represents a distinct entity among those with metastatic disease and consists of patients with metastases limited in number and location, representing an intermediate state between locally confined and widely metastatic cancer. Although similar, "oligorecurrence" (limited number of metachronous metastases under conditions of a controlled primary lesion) and "oligoprogressive" (disease progression at a limited number of sites with disease controlled at other disease sites) states are distinct entities. In non-small cell lung cancer (NSCLC), the oligometastatic state is relatively common, with 20% to 50% of patients having oligometastatic disease at diagnosis. This subgroup of patients when receiving ablative therapy, such as surgery or stereotactic body radiation radiotherapy, can obtain markedly long progression-free and overall survival. The role of radical treatment for intracranial oligometastases is well established. Fewer data exist regarding radical treatment of extracranial metastases in lung cancer; however, retrospective series using surgery or stereotactic body radiotherapy for extracranial oligometastatic disease in NSCLC have shown excellent local control, with a suggestion of improvement in progression-free survival. In the present report, we have reviewed the data on the treatment of brain metastases in oligometastatic NSCLC and the results of ablative treatment of extracranial sites. Recently, the first randomized trial comparing ablative treatment versus control in oligometastatic disease was reported, and those data are reviewed in the context of smaller series. Finally, areas of controversy are discussed and a therapeutic approach for patients with oligometastatic disease is proposed. |
| Databáze: | OpenAIRE |
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