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寡转移癌患者接受转移灶定向立体定向放疗后的急性毒性:E-RADIatE OligoCare 队列的中期分析。

Acute toxicity in patients with oligometastatic cancer following metastasis-directed stereotactic body radiotherapy: An interim analysis of the E-RADIatE OligoCare cohort.

机构信息

Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy; University of Brescia, Brescia, Italy.

Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy.

出版信息

Radiother Oncol. 2024 Oct;199:110466. doi: 10.1016/j.radonc.2024.110466. Epub 2024 Jul 31.

Abstract

AIM

To evaluate acute toxicity at 6 months after stereotactic body radiotherapy (SBRT) in patients with oligometastatic cancer within the OligoCare cohort.

MATERIAL AND METHODS

OligoCare is a prospective, registry-based, single-arm, observational study that aims to report prospective real-world data of patients with oligometastases from solid cancer treated with SBRT (NCT03818503). Primary tumor included non-small cell lung cancer (NSCLC), breast cancer (BC), colorectal cancer (CRC), and prostate cancer (PC). This analysis addresses a secondary endpoint of the trial, acute toxicity within 6 months after SBRT.

RESULTS

Out of 1,597registered patients, 1'468 patients were evaluated for acute toxicity. Globally, 290 (20 %) had NSCLC primary disease, 227 (16 %) had BC, 293 (20 %) had CRC, and 658 (45 %) had PC. Concomitant systemic treatment was administered in 527 (35.9 %) patients. According to the EORTC/ESTRO oligometastatic disease (OMD) classification, 828 (56 %) patients had de novo OMD, 464 (32 %) repeat OMD, and 176 (12 %) induced OMD. Acute grade ≥ 3 SBRT related adverse events were reported in 8 (0.5 %) patients, including 2 (0.1 %) fatal AEs. In particular, 6 (0.4 %) grade 3 events were: 1 empyema, 1 pneumonia, 1 radiation pneumonitis, 1 radiation skin injury, 1 decreased appetite, and 1 bone pain. Among those 2 occurred in NSCLC patients, 2 in BC patients, and 1 in CRC and PC patients each. The two (0.1 %) grade 5 toxicity were represented by: pneumonitis and cerebral hemorrhage.

CONCLUSION

OligoCare is the largest prospective registry cohort on oligometastatic disease. Acute toxicity within 6 months was low, confirming the safety of SBRT in the treatment of oligometastases.

摘要

目的

在 OligoCare 队列中评估寡转移癌患者立体定向体部放疗(SBRT)后 6 个月的急性毒性。

材料和方法

OligoCare 是一项前瞻性、基于登记的、单臂、观察性研究,旨在报告接受 SBRT 治疗的寡转移患者的前瞻性真实世界数据(NCT03818503)。原发肿瘤包括非小细胞肺癌(NSCLC)、乳腺癌(BC)、结直肠癌(CRC)和前列腺癌(PC)。本分析是该试验的次要终点之一,即 SBRT 后 6 个月内的急性毒性。

结果

在 1597 名登记患者中,有 1468 名患者接受了急性毒性评估。总体而言,290 名(20%)患者患有 NSCLC 原发疾病,227 名(16%)患者患有 BC,293 名(20%)患者患有 CRC,658 名(45%)患者患有 PC。527 名(35.9%)患者同时接受了系统治疗。根据 EORTC/ESTRO 寡转移疾病(OMD)分类,828 名(56%)患者为新发 OMD,464 名(32%)为重复 OMD,176 名(12%)为诱导 OMD。8 名(0.5%)患者报告了 SBRT 相关的急性等级≥3 不良事件,包括 2 例(0.1%)致命 AE。特别是,有 6 例(0.4%)为 3 级事件:1 例脓胸,1 例肺炎,1 例放射性肺炎,1 例放射性皮肤损伤,1 例食欲下降和 1 例骨痛。其中 2 例发生在 NSCLC 患者中,2 例发生在 BC 患者中,1 例发生在 CRC 和 PC 患者中。2 例(0.1%)为 5 级毒性,分别为肺炎和脑出血。

结论

OligoCare 是最大的寡转移疾病前瞻性登记队列。6 个月内的急性毒性较低,证实了 SBRT 在治疗寡转移中的安全性。

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