Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Radiol Med. 2023 May;128(5):619-627. doi: 10.1007/s11547-023-01627-4. Epub 2023 Apr 20.
Stereotactic body radiotherapy is increasingly used for the treatment of oligometastatic disease. Magnetic resonance-guided stereotactic radiotherapy (MRgSBRT) offers the opportunity to perform dose escalation protocols while reducing the unnecessary irradiation of the surrounding organs at risk. The aim of this retrospective, monoinstitutional study is to evaluate the feasibility and clinical benefit (CB) of MRgSBRT in the setting of oligometastatic patients.
Data from oligometastatic patients treated with MRgSBRT were collected. The primary objectives were to define the 12-month progression-free survival (PFS) and local progression-free survival (LPFS) and 24-month overall survival (OS) rate. The objective response rate (ORR) included complete response (CR) and partial response (PR). CB was defined as the achievement of ORR and stable disease (SD). Toxicities were also assessed according to the CTCAE version 5.0 scale.
From February 2017 to March 2021, 59 consecutive patients with a total of 80 lesions were treated by MRgSBRT on a 0.35 T hybrid unit. CR and PR as well as SD were observed in 30 (37.5%), 7 (8.75%), and 17 (21.25%) lesions, respectively. Furthermore, CB was evaluated at a rate of 67.5% with an ORR of 46.25%. Median follow-up time was 14 months (range: 3-46 months). The 12-month LPFS and PFS rates were 70% and 23%, while 24-month OS rate was 93%. No acute toxicity was reported, whereas late pulmonary fibrosis G1 was observed in 9 patients (15.25%).
MRgSBRT was well tolerated by patients with reported low toxicity levels and a satisfying CB.
立体定向体放射治疗（SBRT）越来越多地用于治疗寡转移疾病。磁共振引导的立体定向放射治疗（MRgSBRT）提供了在减少周围危及器官不必要照射的同时进行剂量递增方案的机会。本回顾性单中心研究的目的是评估寡转移患者中 MRgSBRT 的可行性和临床获益（CB）。
收集了接受 MRgSBRT 治疗的寡转移患者的数据。主要目的是定义 12 个月无进展生存率（PFS）和局部无进展生存率（LPFS）和 24 个月总生存率（OS）率。客观缓解率（ORR）包括完全缓解（CR）和部分缓解（PR）。CB 定义为 ORR 和疾病稳定（SD）的实现。还根据 CTCAE 版本 5.0 量表评估了毒性。
从 2017 年 2 月至 2021 年 3 月，在 0.35 T 混合单元上对 59 例总计 80 个病灶的连续患者进行了 MRgSBRT 治疗。CR、PR 和 SD 分别在 30 个（37.5%）、7 个（8.75%）和 17 个（21.25%）病灶中观察到。此外，以 67.5%的比例评估 CB，ORR 为 46.25%。中位随访时间为 14 个月（范围：3-46 个月）。12 个月 LPFS 和 PFS 率分别为 70%和 23%，24 个月 OS 率为 93%。没有报告急性毒性，而 9 例（15.25%）患者出现晚期肺部纤维化 G1。
MRgSBRT 耐受性良好，报告的毒性水平较低，CB 令人满意。
