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).
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.
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).
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
AuthorsStefano Ursino, Sabrina Montrone, Martina Cantarella, Valentina Menghini, Fabrizio Matteucci, Valentina Mazzotti, Francesco Fiorica, David Fedele, Paola Erba, Riccardo Morganti, Maria Grazia Fabrini, Davide Caramella
- • Accepted on 31/08/2015
- • Available online on 30/09/2015
- • Published in print on 04/02/2016
This article is available as full text PDF.
- Ursino, Stefano [PubMed] [Google Scholar] 1, * Corresponding Author (email@example.com)
- Montrone, Sabrina [PubMed] [Google Scholar] 1
- Cantarella, Martina [PubMed] [Google Scholar] 1
- Menghini, Valentina [PubMed] [Google Scholar] 1
- Matteucci, Fabrizio [PubMed] [Google Scholar] 1
- Mazzotti, Valentina [PubMed] [Google Scholar] 1
- Fiorica, Francesco [PubMed] [Google Scholar] 2
- Fedele, David [PubMed] [Google Scholar] 3
- Erba, Paola [PubMed] [Google Scholar] 4
- Morganti, Riccardo [PubMed] [Google Scholar] 5
- Fabrini, Maria Grazia [PubMed] [Google Scholar] 1
- Caramella, Davide [PubMed] [Google Scholar] 6
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