Yamashita Hideomi, Niibe Yuzuru, Yamamoto Takaya, Katsui Kuniaki, Jingu Keiichi, Kanazawa Susumu, Terahara Atsuro, Nakagawa Keiichi
Department of Radiology, University of Tokyo Hospital, Tokyo.
Department of Radiology, Toho University Omori Medical Center, Tokyo Division of Radiation Oncology, St. Luke's International Hospital, Tokyo
Jpn J Clin Oncol. 2016 Jul;46(7):687-91. doi: 10.1093/jjco/hyw047. Epub 2016 May 9.
Oligometastases can be divided into sync-oligometastases and oligo-recurrence. The difference is whether the primary site is uncontrolled or controlled. The goal of this multicenter study was to evaluate treatment outcomes and factors affecting survival after stereotactic body radiotherapy for pulmonary oligometastases.
The information after stereotactic body radiotherapy from January 2004 to April 2014 was retrospectively collected. Ninety-six patients (65 males, 31 females) were enrolled. Ten cases (10%) were sync-oligometastases, 79 cases (82%) were oligo-recurrences and 7 (7%) were unclassified oligometastases with <6 months of disease-free interval. The median disease-free interval between initial therapy and stereotactic body radiotherapy was 24 months. The median calculated biological effective dose was 105.6 Gy.
The median follow-up period was 32 months for survivors. The 3-year overall survival and relapse-free survival rates were 53% and 32%, respectively. No Grade 5 toxicity occurred. The median overall survival was 23.9 months for sync-oligometastases and 66.6 months for oligo-recurrence (P = 0.0029). On multivariate analysis, sync-oligometastases and multiple oligometastatic tumors were significant unfavorable factors for both overall survival and relapse-free survival.
In stereotactic body radiotherapy for oligometastatic lung tumors, the state of oligo-recurrence has the potential of a significant prognostic factor for survival.
寡转移可分为同步寡转移和寡复发。区别在于原发部位是未控制还是已控制。本多中心研究的目的是评估立体定向体部放疗治疗肺寡转移后的治疗效果及影响生存的因素。
回顾性收集2004年1月至2014年4月立体定向体部放疗后的信息。纳入96例患者(男性65例,女性31例)。10例(10%)为同步寡转移,79例(82%)为寡复发,7例(7%)为无病间期<6个月的未分类寡转移。初始治疗与立体定向体部放疗之间的中位无病间期为24个月。计算得到的中位生物等效剂量为105.6 Gy。
幸存者的中位随访期为32个月。3年总生存率和无复发生存率分别为53%和32%。未发生5级毒性反应。同步寡转移的中位总生存期为23.9个月,寡复发为66.6个月(P = 0.0029)。多因素分析显示,同步寡转移和多发寡转移瘤是总生存和无复发生存的显著不利因素。
在立体定向体部放疗治疗寡转移肺肿瘤中,寡复发状态有可能成为生存的重要预后因素。