Department of Radiology, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo 060-8638, Japan.
Jpn J Clin Oncol. 2010 Aug;40(8):788-94. doi: 10.1093/jjco/hyq044. Epub 2010 Apr 20.
Several recent studies have shown that oligometastatic disease has curative potential, although it was previously considered to signal a patient's last stage of life. Stereotactic body radiotherapy has been available for extra-cranial metastases in addition to stereotactic cranial radiotherapy for brain metastases. The aim of the present study was to retrospectively evaluate the clinical outcomes of stereotactic radiotherapy for patients with oligometastatic lesions.
Between 1999 and 2008, 41 patients with five or fewer detectable metastases were treated with stereotactic radiotherapy at our institution. The treated oligometastatic lesions were in the brain, lung and adrenal glands.
With a median follow-up period of 20 months, the 3-year overall survival, progression-free survival, local control and distant control rates were 39%, 20%, 80% and 35%, respectively, and the respective 5-year rates were 28%, 20%, 80% and 35%. The median survival time was 24 months. According to interval to recurrence, the 3- and 5-year overall survival rates were 19% and 10%, respectively, for patients with <12 months (n = 18), compared with 53% and 40% for those with > or =12 months (n = 23) (P = 0.006).
Precise stereotactic radiotherapy was effective in controlling oligometastatic lesions for patients with a median survival time of 24 months. Interval to recurrence may impact the overall survival rate and should be included in the stratification criteria in a prospective randomized trial to investigate the benefits of stereotactic radiotherapy for patients with oligometastases.
几项最近的研究表明，寡转移疾病具有治愈的潜力，尽管它以前被认为是患者生命的最后阶段的信号。立体定向体部放射治疗除了用于脑转移的立体定向放射治疗之外，还可用于颅外转移。本研究的目的是回顾性评估立体定向放疗治疗寡转移病变患者的临床结果。
1999 年至 2008 年期间，我院对 41 例 5 个或 5 个以下可检测转移灶的患者进行了立体定向放疗。治疗的寡转移病灶位于脑、肺和肾上腺。
中位随访时间为 20 个月，3 年总生存率、无进展生存率、局部控制率和远处控制率分别为 39%、20%、80%和 35%，5 年分别为 28%、20%、80%和 35%。中位生存时间为 24 个月。根据复发间隔，18 例<12 个月（n=18）患者的 3 年和 5 年总生存率分别为 19%和 10%，而>或=12 个月（n=23）患者的 3 年和 5 年总生存率分别为 53%和 40%（P=0.006）。
精确的立体定向放疗对中位生存时间为 24 个月的寡转移病灶患者有效。复发间隔可能影响总生存率，应纳入前瞻性随机试验的分层标准，以研究立体定向放疗对寡转移患者的益处。
