Dirkx Silke, Van Laere Sven, Gevaert Thierry, De Ridder Mark
Department of Radiotherapy, Research Centre for Digital Medicine, VUB-UZ Brussel, 1090 Brussels, Belgium.
Cancers (Basel). 2025 Jan 17;17(2):296. doi: 10.3390/cancers17020296.
: Inadequate dosing and respiratory motion contribute to local recurrence for oligometastatic disease (OMD). While short-term LC rates are well-documented, data on long-term LC remain limited. This study investigated long-term LC after stereotactic body radiotherapy (SBRT), using respiratory motion management techniques. This retrospective study took place at UZ Brussel with follow-up until Oct 2024. It analyzed oligometastatic patients treated with SBRT between Jul 2012 and Feb 2017. Treatment involved delivering 50 Gy in 10 fractions on the 80% isodose line, building on data from a prior prospective study. Lesion movement was managed using internal target volume (ITV) or dynamic tumor tracking (DTT) with marker. The primary endpoint of the study was long-term LC and identifying variables associated with it using a Cox proportional hazards model. : A total of 100 patients were treated for a total of 211 metastatic lesions. Lesions were predominantly in the lungs (74%) and treated using ITV (88%). LC rates at 1, 3, 5, and 10 years were 76.5%, 53.8%, 38.1%, and 36.3%, respectively. Improved LC was observed in locations other than lung and liver (HR: 0.309; = 0.024) and with increasing age (HR: 0.975; < 0.010). Worse LC was seen in liver lesions (HR: 1.808; = 0.103) and systemic therapy post-radiotherapy (HR: 3.726; < 0.001). No significant associations were found with tumor size or tumor motion, nor between the two motion management strategies used (DTT and ITV). : Appropriate motion management is key in LC for OMD. No significant difference in LC was found between both techniques. Lesion location, patient age, and systemic therapy post-radiotherapy were prognostic factors for LC.
剂量不足和呼吸运动是寡转移性疾病（OMD）局部复发的原因。虽然短期局部控制（LC）率已有充分记录，但长期LC的数据仍然有限。本研究使用呼吸运动管理技术，调查了立体定向体部放疗（SBRT）后的长期LC情况。这项回顾性研究在布鲁塞尔大学医院进行，随访至2024年10月。它分析了2012年7月至2017年2月期间接受SBRT治疗的寡转移性患者。治疗方案是根据先前一项前瞻性研究的数据，在80%等剂量线上分10次给予50 Gy。使用内部靶区（ITV）或带标记的动态肿瘤追踪（DTT）来管理病灶运动。该研究的主要终点是长期LC，并使用Cox比例风险模型确定与之相关的变量。
共有100名患者接受了治疗，总共211个转移病灶。病灶主要位于肺部（74%），并使用ITV进行治疗（88%）。1年、3年、5年和10年的LC率分别为76.5%、53.8%、38.1%和36.3%。在肺和肝以外的部位观察到LC改善（风险比：0.309；P = 0.024），且随着年龄增长LC改善（风险比：0.975；P < 0.010）。肝部病灶的LC较差（风险比：1.808；P = 0.103），放疗后进行全身治疗的LC也较差（风险比：3.726；P < 0.001）。未发现与肿瘤大小或肿瘤运动有显著关联，两种运动管理策略（DTT和ITV）之间也无显著关联。
适当的运动管理是OMD的LC的关键。两种技术在LC方面未发现显著差异。病灶位置、患者年龄和放疗后全身治疗是LC的预后因素。
