Aquilano Michele, Loi Mauro, Visani Luca, Livi Lorenzo, Nuyttens Joost J
Radiation Oncology, Mater Olbia Hospital, Olbia, Italy.
Department of Radiation Oncology, University of Florence, Florence, Italy.
Acta Oncol. 2023 Mar;62(3):298-304. doi: 10.1080/0284186X.2023.2186187. Epub 2023 Mar 11.
Oligoprogression (OPD) is defined as a condition where limited progression (1-3 metastases) is observed in patients undergoing systemic cancer treatment. In this study we investigated the impact of stereotactic body radiotherapy (SBRT) in patients with OPD from metastatic lung cancer.
Data from a cohort of consecutive patients with SBRT treated between June 2015 and August 2021 were collected. All extracranial metastatic sites of OPD from lung cancer were included. Dose regimens consisted of mainly 24 in 2 fractions, 30-51 Gy in 3 fractions, 30-55 Gy in 5 fractions, 52.5 Gy in 7 fractions and 44-56 Gy in 8 fractions. Kaplan-Meier method was used to calculate Overall Survival (OS), Local Control (LC), and Disease-Free Survival (DFS) from the start date of SBRT to the event.
Sixty-three patients, 34 female and 29 males were included. Median age was 75 years (range 25-83). All patients received concurrent systemic treatment before the start of the SBRT: 19 chemotherapy (CT), 26 CT plus immunotherapy (IT) or Tyrosin kinase inhibitors (TKI) and 18 IT/TKI. SBRT was delivered to the lung ( = 29), mediastinal node ( = 9), bone ( = 7), adrenal gland ( = 19), other visceral metastases (1) and other node metastases ( = 4). After a median follow-up of 17 months, median OS was 23 months. LC was 93% at 1 year and 87% at 2 years. DFS was 7 months. According to our results, there was no statistically significant correlation between prognostic factors and OS after SBRT in OPD patients.
Median DFS was 7 months, translating into the continuation of effective systemic treatment as other metastases grow slowly. In patients with oligoprogression disease, SBRT is a valid and efficient treatment that may enable postponing the switch of systemic line.
寡进展（OPD）定义为在接受全身性癌症治疗的患者中观察到有限进展（1 - 3个转移灶）的情况。在本研究中，我们调查了立体定向体部放疗（SBRT）对转移性肺癌寡进展患者的影响。
收集了2015年6月至2021年8月期间接受SBRT治疗的连续患者队列的数据。纳入了所有肺癌寡进展的颅外转移部位。剂量方案主要包括24Gy分2次、30 - 51Gy分3次、30 - 55Gy分5次、52.5Gy分7次以及44 - 56Gy分8次。采用Kaplan - Meier方法计算从SBRT开始日期到事件发生的总生存期（OS）、局部控制率（LC）和无病生存期（DFS）。
纳入63例患者，其中女性34例，男性29例。中位年龄为75岁（范围25 - 83岁）。所有患者在SBRT开始前均接受了同步全身治疗：19例接受化疗（CT），26例接受CT加免疫治疗（IT）或酪氨酸激酶抑制剂（TKI），18例接受IT/TKI。SBRT照射部位为肺（n = 29）、纵隔淋巴结（n = 9）、骨（n = 7）、肾上腺（n = 19）、其他内脏转移灶（1例）和其他淋巴结转移灶（n = 4）。中位随访17个月后，中位OS为23个月。1年时LC为93%，2年时为87%。DFS为7个月。根据我们的结果，OPD患者SBRT后的预后因素与OS之间无统计学显著相关性。
中位DFS为7个月，这意味着随着其他转移灶生长缓慢，有效的全身治疗得以持续。在寡进展性疾病患者中，SBRT是一种有效的治疗方法，可能能够推迟全身治疗方案的更换。
