Advertisement

Stereotactic body radiotherapy of bone metastases in oligometastatic disease: prognostic factors of oncologic outcomes

Abstract

Background

To evaluate the safety of stereotactic body radiotherapy (SBRT) of bone metastases in oligometastatic disease and to investigate prognostic factors of local control (LC), progression/disease-free survival (PDFS), and overall survival (OS).

Methods

Eligibility criteria were number of metastates ≤5, controlled primary tumor without evidence of progression under systemic therapy, exclusion of surgery, and no previous radiotherapy of the lesion of interest. Oligometastatic status was classified into only bone (BOD) and outside bone disease (OBOD), whereas SBRT was delivered to bone lesions using 2 different schedules: 24 Gy/1 fraction or 27 Gy/3 fractions. A positron emission tomography study of the lesion of interest was performed at baseline and at 3 months after SBRT to evaluate metabolic response according to European Organization for Research and Treatment of Cancer (EORTC) criteria. A Cox regression model was used for univariate and multivariate analysis.

Results

Between January 2010 and December 2013, 40 patients were enrolled. Only 1 patient experienced severe late toxicity (radiation-related fracture). Local control was longer among responders’ than nonresponders’ lesions (94.2% and 91.2% versus 63% and 35% at 1 and 2 years, respectively) (p = 0.004; hazard ratio = 9.958). The multivariate analysis of PDFS showed a significant correlation with planning target volume (PTV) size (p = 0.003) and oligometastatic status (p = 0.002). The multivariate analysis of OS confirmed a statistically significant value of the oligometastatic status (p = 0.002) and a significant trend for PTV size (p = 0.065).

Conclusions

Stereotactic body radiotherapy is safe with a low incidence of severe toxicity. Positron emission tomography response was a strong prognostic factor of LC whereas BOD status and small PTV size could identify a subset of oligometastatic patients at better prognosis.

Tumori 2016; 102(1): 59 - 64

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000441

Authors

Stefano Ursino, Sabrina Montrone, Martina Cantarella, Valentina Menghini, Fabrizio Matteucci, Valentina Mazzotti, Francesco Fiorica, David Fedele, Paola Erba, Riccardo Morganti, Maria Grazia Fabrini, Davide Caramella

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

This article is available as full text PDF.

  • If you are a Subscriber, please log in now.

  • Article price: Eur 36,00
  • You will be granted access to the article for 72 hours and you will be able to download any format (PDF or ePUB). The article will be available in your login area under "My PayPerView". You will need to register a new account (unless you already own an account with this journal), and you will be guided through our online shop. Online purchases are paid by Credit Card through PayPal.
  • If you are not a Subscriber you may:
  • Subscribe to this journal
  • Unlimited access to all our archives, 24 hour a day, every day of the week.

Authors

Affiliations

  • Department of Radiation Oncology, S. Chiara University Hospital, Pisa - Italy
  • Department of Radiation Oncology, University Hospital of Ferrara, Ferrara - Italy
  • Radiotherapy of Casa di Cura San Rossore, Pisa - Italy
  • Department of Nuclear Medicine, S. Chiara University Hospital, Pisa - Italy
  • Biostatistical Consulting, Department of Oncology, University Hospital S. Chiara, Pisa - Italy
  • Department of Radiology, S. Chiara University Hospital, Pisa - Italy

Article usage statistics

The blue line displays unique views in the time frame indicated.
The yellow line displays unique downloads.
Views and downloads are counted only once per session.

No supplementary material is available for this article.