Skip to main content

Advertisement

SpringerLink
Log in

Stereotactic body radiation therapy in the treatment of cancer patients with oligometastatic disease: a real world study

  • Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Purpose

Stereotactic body radiation therapy (SBRT) is a treatment modality with curative intent for oligometastatic cancer patients, commonly defined by a low-burden metastatic disease with 1–5 systemic metastases. Better knowledge of the clinical profile and prognostic factors in oligometastatic cancer patients could help to improve the selection of candidates who may obtain most benefits from SBRT. The objective of this study was to describe the clinical data and outcome in term of overall survival (OS) of patients with oligometastatic disease treated with SBRT over a 6-year period.

Methods

From 2013 to 2018, 284 solid tumor cancer patients with 1–5 oligometastases underwent SBRT at a large university-affiliated oncological center in Barcelona, Spain. Variables related to the patient profile, tumor, oligometastatic disease, and treatment were evaluated.

Results

A total of 327 metastatic tumors were treated with SBRT. In 65.5% of cases, metachronous tumors were diagnosed at least 1 year after diagnosis of the primary tumor. The median age of the patients was 73.9 years and 66.5% were males. The median follow-up was 37.5 months. The most common primary tumors were lung and colorectal cancer, with lung and bone as the most commonly treated metastatic sites. Ninety-three percent of patients showed a Karnofsky score (KPS) between 80 and 100. Adenocarcinoma was the most common histological type. The median overall survival was 53.4 months, with 1-, 2- and 5-year survival rates of 90.5%, 73.9% and 43.4%, respectively. Overall survival rates of breast (67.6 months, 95% CI 56.4–78.9), urological (63.3 months, 95% CI 55.8–70.8), and colorectal (50.8 months, 95% CI 44.2–57.4) tumors were higher as compared with other malignancies (20 months, 95% CI 11.2–28.8 months) (p < 0.001). Patients with Karnofsky score (KPS) of 90 and 100 showed a significantly better survival than those with impaired performance status (p = 0.001).

Conclusion

SBRT appears to be well tolerated and safe approach in oligometastatic patients. Patients with good performance status and with primary breast, urological and colorectal cancer have higher OS compared with other malignancies. More studies are necessary to evaluate the prognostic factors in oligometastatic disease (OMD) in order to select patients who could benefit more from this therapeutic approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data will be made available on request to the authors.

References

  1. Reyes DK, Pienta KJ. The biology and treatment of oligometastatic cancer. Oncotarget. 2015;6(11):8491–524. https://doi.org/10.18632/oncotarget.3455.

    Article  Google Scholar 

  2. Guckenberger M, Lievens Y, Bouma AB, Collette L, Dekker A, deSouza NM, Dingemans AC, Fournier B, Hurkmans C, Lecouvet FE, Meattini I, Méndez Romero A, Ricardi U, Russell NS, Schanne DH, Scorsetti M, Tombal B, Verellen D, Verfaillie C, Ost P. Characterisation and classification of oligometastatic disease: a European Society for Radiotherapy and Oncology and European Organisation for Research and Treatment of Cancer consensus recommendation. Lancet Oncol. 2020;21(1):e18–28. https://doi.org/10.1016/S1470-2045(19)30718-1.

    Article  Google Scholar 

  3. Ahmed KA, Torres-Roca JF. Stereotactic body radiotherapy in the management of oligometastatic disease. Cancer Control. 2016;23(1):21–9. https://doi.org/10.1177/107327481602300105.

    Article  Google Scholar 

  4. Lievens Y, Guckenberger M, Gomez D, Hoyer M, Iyengar P, Kindts I, Méndez Romero A, Nevens D, Palma D, Park C, Ricardi U, Scorsetti M, Yu J, Woodward WA. Defining oligometastatic disease from a radiation oncology perspective: An ESTRO-ASTRO consensus document. Radiother Oncol. 2020;148:157–66. https://doi.org/10.1016/j.radonc.2020.04.003.

    Article  Google Scholar 

  5. Zayed S, Correa RJM, Palma DA. Radiation in the treatment of oligometastatic and oligoprogressive disease: rationale, recent data, and research questions. Cancer J. 2020;26(2):156–65. https://doi.org/10.1097/PPO.0000000000000436.

    Article  Google Scholar 

  6. Milano MT, Katz AW, Zhang H, Huggins CF, Aujla KS, Okunieff P. Oligometastatic breast cancer treated with hypofractionated stereotactic radiotherapy: some patients survive longer than a decade. Radiother Oncol. 2019;131:45–51. https://doi.org/10.1016/j.radonc.2018.11.022.

    Article  Google Scholar 

  7. Engels B, Everaert H, Gevaert T, Duchateau M, Neyns B, Sermeus A, Tournel K, Verellen D, Storme G, De Ridder M. Phase II study of helical tomotherapy for oligometastatic colorectal cancer. Ann Oncol. 2011;22(2):362–8. https://doi.org/10.1093/annonc/mdq385.

    Article  CAS  Google Scholar 

  8. Franceschini D, De Rose F, Franzese C, Comito T, Di Brina L, Radicioni G, Evangelista A, D’Agostino GR, Navarria P, Scorsetti M. Predictive factors for response and survival in a cohort of oligometastatic patients treated with stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2019;104(1):111–21. https://doi.org/10.1016/j.ijrobp.2018.12.049.

    Article  Google Scholar 

  9. Aujla KS, Katz AW, Singh DP, Okunieff P, Milano MT. Hypofractionated stereotactic radiotherapy for non-breast or prostate cancer oligometastases: a tail of survival beyond 10 years. Front Oncol. 2019;9:111. https://doi.org/10.3389/fonc.2019.00111.

    Article  Google Scholar 

  10. Macchia G, Lazzari R, Colombo N, Laliscia C, Capelli G, D’Agostino GR, Deodato F, Maranzano E, Ippolito E, Ronchi S, Paiar F, Scorsetti M, Cilla S, Ingargiola R, Huscher A, Cerrotta AM, Fodor A, Vicenzi L, Russo D, Borghesi S, Perrucci E, Pignata S, Aristei C, Morganti AG, Scambia G, Valentini V, Jereczek-Fossa BA, Ferrandina G. A Large, multicenter, retrospective study on efficacy and safety of stereotactic body radiotherapy (SBRT) in oligometastatic ovarian cancer (MITO RT1 Study): a collaboration of MITO, AIRO GYN, and MaNGO Groups. Oncologist. 2020;25(2):e311–20. https://doi.org/10.1634/theoncologist.2019-0309.

    Article  Google Scholar 

  11. Brown JM, Carlson DJ, Brenner DJ. The tumor radiobiology of SRS and SBRT: are more than the 5 Rs involved? Int J Radiat Oncol Biol Phys. 2014;88(2):254–62. https://doi.org/10.1016/j.ijrobp.2013.07.022.

    Article  Google Scholar 

  12. Navarro-Martín A, Galiana IL, Berenguer Frances MA, Cacicedo J, Cañas Cortés R, Comas Anton S, Padrones Sánchez S, Bolívar Cuevas S, Parry R, Guedea Edo F. Preliminary study of the effect of stereotactic body radiotherapy (SBRT) on the immune system in lung cancer patients unfit for surgery: immunophenotyping analysis. Int J Mol Sci. 2018;19(12):3963. https://doi.org/10.3390/ijms19123963.

    Article  Google Scholar 

  13. Linares-Galiana I, Berenguer-Frances MA, Cañas-Cortés R, Pujol-Canadell M, Comas-Antón S, Martínez E, Laplana M, Pérez-Montero H, Pla-Farnós MJ, Navarro-Martin A, Nuñez M, Both B, Guedea F. Changes in peripheral immune cells after intraoperative radiation therapy in low-risk breast cancer. J Radiat Res. 2021;62(1):110–8. https://doi.org/10.1093/jrr/rraa083.

    Article  CAS  Google Scholar 

  14. Berenguer Frances MA, Linares-Galiana I, Cañas Cortés R, Marín I, Borrás S, Gutiérrez Miguélez C, Najjari D, Slocker A, Bellobí C, Santacana M, Pané Foix M, Alonso MH, Navarro-Martin A, Comas Antón S, Guedea F. Changes of CD68, CD163, and PD-L1 tumor expression during high-dose-rate and pulsed-dose-rate brachytherapy for cervical cancer. Brachytherapy. 2020;19(1):51–9. https://doi.org/10.1016/j.brachy.2019.09.009.

    Article  Google Scholar 

  15. Tree AC, Khoo VS, Eeles RA, Ahmed M, Dearnaley DP, Hawkins MA, Huddart RA, Nutting CM, Ostler PJ, van As NJ. Stereotactic body radiotherapy for oligometastases. Lancet Oncol. 2013;14(1):e28-37. https://doi.org/10.1016/S1470-2045(12)70510-7.

    Article  Google Scholar 

  16. Ashworth AB, Senan S, Palma DA, Riquet M, Ahn YC, Ricardi U, Congedo MT, Gomez DR, Wright GM, Melloni G, Milano MT, Sole CV, De Pas TM, Carter DL, Warner AJ, Rodrigues GB. An individual patient data metaanalysis of outcomes and prognostic factors after treatment of oligometastatic non-small-cell lung cancer. Clin Lung Cancer. 2014;15(5):346–55. https://doi.org/10.1016/j.cllc.2014.04.003.

    Article  Google Scholar 

  17. Tanadini-Lang S, Rieber J, Filippi AR, Fode MM, Streblow J, Adebahr S, Andratschke N, Blanck O, Boda-Heggemann J, Duma M, Eble MJ, Ernst I, Flentje M, Gerum S, Hass P, Henkenberens C, Hildebrandt G, Imhoff D, Kahl H, Klass ND, Krempien R, Lohaus F, Petersen C, Schrade E, Wendt TG, Wittig A, Høyer M, Ricardi U, Sterzing F, Guckenberger M. Nomogram based overall survival prediction in stereotactic body radiotherapy for oligo-metastatic lung disease. Radiother Oncol. 2017;123(2):182–8. https://doi.org/10.1016/j.radonc.2017.01.003.

    Article  CAS  Google Scholar 

  18. Fode MM, Høyer M. Survival and prognostic factors in 321 patients treated with stereotactic body radiotherapy for oligo-metastases. Radiother Oncol. 2015;114(2):155–60. https://doi.org/10.1016/j.radonc.2014.12.003.

    Article  Google Scholar 

  19. Van den Begin R, Engels B, Collen C, de Vin T, Defauw A, Dubaere E, Barbé K, De Ridder M. The METABANK score: a clinical tool to predict survival after stereotactic radiotherapy for oligometastatic disease. Radiother Oncol. 2019;133:113–9. https://doi.org/10.1016/j.radonc.2019.01.001.

    Article  Google Scholar 

  20. de Vin T, Engels B, Gevaert T, Storme G, De Ridder M. Stereotactic radiotherapy for oligometastatic cancer: a prognostic model for survival. Ann Oncol. 2014;25(2):467–71.https://doi.org/10.1093/annonc/mdt537.

  21. Hörner-Rieber J, Bernhardt D, Blanck O, Duma M, Eich HT, Gerum S, Gkika E, Hass P, Henkenberens C, Herold HU, Hildebrandt G, Imhoff D, Kahl H, Janssen S, Jurianz K, Krempien R, Lautenschläger SF, Lohaus F, Mueller AC, Petersen C, Sackerer I, Scafa D, Schrade E, Uhlmann L, Wittig A, Guckenberger M. Long-term follow-up and patterns of recurrence of patients with oligometastatic nsclc treated with pulmonary SBRT. Clin Lung Cancer. 2019;20(6):e667–77. https://doi.org/10.1016/j.cllc.2019.06.024.

    Article  Google Scholar 

  22. König L, Häfner MF, Katayama S, Koerber SA, Tonndorf-Martini E, Bernhardt D, von Nettelbladt B, Weykamp F, Hoegen P, Klüter S, Susko MS, Debus J, Hörner-Rieber J. Stereotactic body radiotherapy (SBRT) for adrenal metastases of oligometastatic or oligoprogressive tumor patients. Radiat Oncol. 2020;15(1):30. https://doi.org/10.1186/s13014-020-1480-0.

    Article  CAS  Google Scholar 

  23. Engels B, Gevaert T, Everaert H, De Coninck P, Sermeus A, Christian N, Storme G, Verellen D, De Ridder M. Phase II study of helical tomotherapy in the multidisciplinary treatment of oligometastatic colorectal cancer. Radiat Oncol. 2012;7:34. https://doi.org/10.1186/1748-717X-7-34.

    Article  Google Scholar 

  24. Collen C, Christian N, Schallier D, Meysman M, Duchateau M, Storme G, De Ridder M. Phase II study of stereotactic body radiotherapy to primary tumor and metastatic locations in oligometastatic nonsmall-cell lung cancer patients. Ann Oncol. 2014;25(10):1954–9. https://doi.org/10.1093/annonc/mdu370.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors thank Marta Pulido, MD, for editing the manuscript.

Funding

Radiation Oncology Department, Institut Català d'Oncologia (ICO), L’Hospitalet de Llobregat, Barcelona, Spain.

Author information

Authors and Affiliations

  1. Radiation Oncology Department, Hospital Duran i Reynals, Institut Català d’Oncologia (ICO), Avinguda de la Gran Via de l’Hospitalet 199-203, L’Hospitalet de Llobregat, 08098, Barcelona, Spain

    Milica Stefanovic, Gemma Calvet, Héctor Pérez-Montero, Montse Ventura Bujalance, Arturo Navarro-Martín, Maria Dolores Arnaiz Fernández, Ferran Ferrer González, Susanna Marin Borras, Alicia Lozano Borbalas, Miriam Nuñez Fernandez, Miquel Macia Garau, Anna Lucas Calduch & Ferran Guedea Edo

  2. Radiobiology and Cancer Group, ONCOBELL Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Avinguda de la Gran Via de l’Hospitalet 199-203, L’Hospitalet de Llobregat, 08098, Barcelona, Spain

    Milica Stefanovic, Héctor Pérez-Montero, Montse Ventura Bujalance, Arturo Navarro-Martín, Ferran Ferrer González, Miriam Nuñez Fernandez, Miquel Macia Garau, Anna Lucas Calduch & Ferran Guedea Edo

  3. Badalona Applied Research Group in Oncology (B·ARGO), Oncology Data Analytics Program (ODAP), Institut Català d’Oncologia (ICO), Institut Català d’Oncologia (ICO Badalona), Hospital Universitari Germans Trias i Pujol, Carretera de Canyet s/n, Badalona, 08916, Barcelona, Spain

    Anna Esteve

  4. Department of Clinical Sciences, University of Barcelona, Bellvitge Campus, Avinguda de la Gran Via de l’Hospitalet 199-203, L’Hospitalet de Llobregat, 08098, Barcelona, Spain

    Arturo Navarro-Martín, Ferran Ferrer González, Susanna Marin Borras, Miquel Macia Garau & Ferran Guedea Edo

Authors
  1. Milica Stefanovic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gemma Calvet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Héctor Pérez-Montero
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Esteve
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Montse Ventura Bujalance
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Arturo Navarro-Martín
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Maria Dolores Arnaiz Fernández
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ferran Ferrer González
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Susanna Marin Borras
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alicia Lozano Borbalas
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Miriam Nuñez Fernandez
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Miquel Macia Garau
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Anna Lucas Calduch
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ferran Guedea Edo
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

GC literature review, data collection, data analysis, writing of the manuscript; MS literature review, design, data collection, interpretation, critical review; HPM interpretation and critical review; AME data analysis, interpretation, critical review; MVB design, review; MMG, ALC, AN-M, MDAF treating physicians, data collection; FGE conception, interpretation, supervision. All authors have seen and approved the final draft.

Corresponding author

Correspondence to Milica Stefanovic.

Ethics declarations

Conflicts of interest

None of the authors have any conflicts of interest to declare.

Ethical approval

Institutional Review Board of Institut Català d'Oncologia (ICO), L’Hospitalet de Llobregat, Barcelona, Spain.

Consent to participate

The study was waived of informed consent as data were collected from retrospective review of electronic medical records.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Stefanovic, M., Calvet, G., Pérez-Montero, H. et al. Stereotactic body radiation therapy in the treatment of cancer patients with oligometastatic disease: a real world study. Clin Transl Oncol 25, 199–206 (2023). https://doi.org/10.1007/s12094-022-02923-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-022-02923-7

Keywords

Search

Navigation