Bessho Ryosuke, Uezono Haruka, Ota Yosuke, Miyazaki Shuichiro, Marudai Mitsuru, Takabayashi Hatamei, Tsujino Kayoko
Department of Radiation Oncology, Hyogo Cancer Center, Akashi, JPN.
Cureus. 2024 May 19;16(5):e60590. doi: 10.7759/cureus.60590. eCollection 2024 May.
The efficacy of local therapy for oligometastatic disease (OMD) remains unclear. This study aimed to evaluate the prognostic utility of the classification system for OMD and explore which groups may benefit from stereotactic body radiation therapy (SBRT).
This single-center retrospective study included 45 patients (52 sites) with solid tumors and 1-3 extracranial oligometastases who underwent SBRT for all metastases at our institution between January 2018 and December 2021. OMD states were classified based on the European Society for Radiotherapy and Oncology (ESTRO) and the European Organisation for Research and Treatment of Cancer (EORTC) classification system. Local control (LC), overall survival (OS), and progression-free survival (PFS) for each group were analyzed using the Kaplan-Meier method. Acute and late adverse events (AEs) were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
The median follow-up period was 14 months (range: 0-48 months). The numbers of patients in the de novo (first diagnosis of OMD), repeat (previous history of OMD), and induced (previous history of polymetastatic disease) OMD groups were 15, 17, and 13, respectively. The LC rates at one year for the entire, de novo, repeat, and induced cohorts were 87.2%, 87.5%, 90.2%, and 83.9%, respectively (p=0.80). The one-year PFS rates for each group were 35.0%, 56.7%, and 29.9%, respectively (p=0.58). The one-year OS rates for each group were 80.0%, 86.2%, and 80.8%, respectively (p=0.50). Grade 2 or 3 AEs occurred in five patients (10.4%). No grade 4 or 5 AEs were observed.
SBRT is safe and highly effective for local control. Patients with repeat OMD demonstrated a trend of longer PFS, suggesting that this subgroup may benefit from local therapy at metastatic sites.
寡转移疾病（OMD）局部治疗的疗效仍不明确。本研究旨在评估OMD分类系统的预后效用，并探索哪些组可能从立体定向体部放射治疗（SBRT）中获益。
本单中心回顾性研究纳入了45例（52个部位）患有实体瘤且有1 - 3个颅外寡转移灶的患者，这些患者于2018年1月至2021年12月在我院接受了针对所有转移灶的SBRT治疗。OMD状态根据欧洲放射治疗与肿瘤学会（ESTRO）和欧洲癌症研究与治疗组织（EORTC）的分类系统进行分类。使用Kaplan - Meier方法分析每组的局部控制（LC）、总生存期（OS）和无进展生存期（PFS）。根据不良事件通用术语标准（CTCAE）第5.0版评估急性和晚期不良事件（AE）。
中位随访期为14个月（范围：0 - 48个月）。初发（首次诊断为OMD）、复发（既往有OMD病史）和诱导（既往有多发性转移疾病病史）OMD组的患者人数分别为15、17和13。整个队列、初发、复发和诱导队列的一年LC率分别为87.2%、87.5%、90.2%和83.9%（p = 0.80）。每组的一年PFS率分别为35.0%、56.7%和29.9%（p = 0.58）。每组的一年OS率分别为80.百分之0、86.2%和80.8%（p = 0.50）。5例患者（10.4%）发生2级或3级AE。未观察到4级或5级AE。
SBRT对局部控制安全且高效。复发OMD患者显示出PFS较长的趋势，表明该亚组可能从转移部位的局部治疗中获益。
