Stereotactic body radiotherapy (SBRT) for medically inoperable lung metastases-A pooled analysis of the German working group 'stereotactic radiotherapy'
| Autor: | Cordula Petersen, Juliane Rieber, Michael Flentje, Guido Hildebrandt, Iris Ernst, Sabine Gerum, Fabian Lohaus, E. Schrade, Nicolaus Andratschke, Matthias Guckenberger, Robert Krempien, H. Kahl, Sonja Adebahr, Jan Streblow, Thomas G. Wendt, N. D. Klass, Lorenz Uhlmann, Andrea Wittig, Peter Hass, Florian Sterzing, Marciana Nona Duma, Oliver Blanck, Detlef Imhoff, Judit Boda-Heggemann, Christoph Henkenberens, Michael J. Eble |
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| Přispěvatelé: | University of Zurich, Guckenberger, Matthias |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Cancer Research Lung Neoplasms medicine.medical_treatment Effective dose (radiation) 030218 nuclear medicine & medical imaging Metastasis 0302 clinical medicine Germany Positron Emission Tomography Computed Tomography 1306 Cancer Research Neoplasm Metastasis 610 Medicine & health Aged 80 and over Radiotherapy Dosage Middle Aged Prognosis Primary tumor 10044 Clinic for Radiation Oncology medicine.anatomical_structure Treatment Outcome Oncology 030220 oncology & carcinogenesis Female 2730 Oncology Radiology Pulmonary and Respiratory Medicine medicine.medical_specialty Radiosurgery Disease-Free Survival 03 medical and health sciences medicine Humans Karnofsky Performance Status Pneumonitis Aged Retrospective Studies Lung Performance status business.industry medicine.disease Radiation therapy Radiation Pneumonitis 2740 Pulmonary and Respiratory Medicine Dose Fractionation Radiation business Nuclear medicine Follow-Up Studies |
| Popis: | Objectives The current literature on stereotactic body radiotherapy (SBRT) for oligometastatic disease is characterized by small patient cohorts with heterogeneous primary tumors, metastases location and dose regimes. Hence, this study established a multi-institutional database of 700 patients treated with SBRT for pulmonary metastases to identify prognostic factors influencing survival and local control. Materials and methods All German radiotherapy departments were contacted and invited to participate in this analysis. A total number of 700 patients with medically inoperable lung metastases treated with SBRT in 20 centers between 1997 and 2014 were included in a database. Primary and metastatic tumor characteristics, treatment characteristics and follow-up data including survival, local control, distant metastases, and toxicity were evaluated. Lung metastases were treated with median PTV-encompassing single doses of 12.5 Gy (range 3.0–33.0 Gy) in a median number of 3 fractions (range 1–13). Results After a median follow-up time of 14.3 months, 2-year local control (LC) and overall survival (OS) were 81.2% and 54.4%, respectively. In multivariate analysis, OS was most significantly influenced by pretreatment performance status, maximum metastasis diameter, primary tumor histology, time interval between primary tumor diagnosis and SBRT treatment and number of metastases. For LC, independent prognostic factors were pretreatment performance status, biological effective dose (BED) at PTV isocenter (BEDISO) and single fraction (PTV-encompassing) dose in multivariate analysis. Radiation-induced pneumonitis grade 2 or higher was observed in 6.5% of patients. The only factor significantly influencing toxicity was BEDISO (p = 0.006). Conclusion SBRT for medically inoperable patients with pulmonary metastases achieved excellent local control and promising overall survival. Important prognostic factors were identified for selecting patients who might benefit most from this therapy approach. |
| Databáze: | OpenAIRE |
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