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Stereotactic body radiotherapy (SBRT) can delay polymetastatic conversion in patients affected by liver oligometastases

  • Original Article – Clinical Oncology
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Abstract

Purpose

SBRT demonstrated to increase survival in oligometastatic patients. Nevertheless, little is known regarding the natural history of oligometastatic disease (OMD) and how SBRT may impact the transition to the polymetastatic disease (PMD).

Methods

97 liver metastases in 61 oligometastatic patients were treated with SBRT. Twenty patients (33%) had synchronous oligometastases, 41 (67%) presented with metachronous oligometastases. Median number of treated metastases was 2 (range 1–5).

Results

Median follow-up was 24 months. Median tPMC was 11 months (range 4–17 months). Median overall survival (OS) was 23 months (range 16–29 months). Cancer-specific survival predictive factors were having further OMD after SBRT (21 months versus 15 months; p = 0.00), and local control of treated metastases (27 months versus 18 months; p = 0.031). Median PFS was 7 months (range 4–12 months). Patients with 1 metastasis had longer median PFS as compared to those with 2–3 and 4–5 metastases (14.7 months versus 5.3 months versus 6.5 months; p = 0.041). At the last follow-up, 50/61 patients (82%) progressed, 16 of which (26.6%) again as oligometastatic and 34 (56%) as polymetastatic.

Conclusion

In the setting of oligometastatic disease, SBRT is able to delay the transition to the PMD. A proportion of patients relapse as oligometastatic and can be eventually evaluated for a further SBRT course. Interestingly, those patients retain a survival benefit as compared to those who had PMD. Further studies are needed to explore the role of SBRT in OMD and to identify treatment strategies able to maintain the oligometastatic state.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, via Don Sempreboni 5, 37034, Verona, Negrar, Italy

    Luca Nicosia, Francesco Cuccia, Rosario Mazzola, Vanessa Figlia, Niccolò Giaj-Levra, Francesco Ricchetti, Michele Rigo & Filippo Alongi

  2. Radiation Oncology Department, ASST Spedali Civili di Brescia, Brescia University, Brescia, Italy

    Marco Bonù

  3. Radiation Oncology Department, University Hospital, LMU Munich, Munich, Germany

    Stefanie Corradini

  4. Department of Radiotherapy/Radiation Oncology, Faculty of Medicine, School of Health Sciences, University of Thessaly, University Hospital of Larisa, Biopolis, 41500, Larisa, Greece

    Maria Tolia

  5. University of Brescia, Brescia, Italy

    Filippo Alongi

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  1. Luca Nicosia
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  2. Francesco Cuccia
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  3. Rosario Mazzola
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Correspondence to Luca Nicosia.

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Nicosia, L., Cuccia, F., Mazzola, R. et al. Stereotactic body radiotherapy (SBRT) can delay polymetastatic conversion in patients affected by liver oligometastases. J Cancer Res Clin Oncol 146, 2351–2358 (2020). https://doi.org/10.1007/s00432-020-03223-9

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