Huck Constance, Kountouri Melpomeni, Yarza Ramon, Marquina Gloria, Espantaleon Manuel, Kroep Judith, Herrera Fernanda, Madariaga Ainhoa, Sanmamed Noelia
Division of Radiation Oncology, University Hospital of Lausanne, Lausanne, Switzerland.
Now at Radio-oncology Department, Bergonie Institut, Bordeaux, France.
Clin Transl Radiat Oncol. 2025 May 17;53:100981. doi: 10.1016/j.ctro.2025.100981. eCollection 2025 Jul.
Managing recurrent oligometastatic ovarian cancer with a limited disease burden is challenging, requiring localized treatments to achieve durable control while reducing systemic therapy exposure. Stereotactic body radiotherapy (SBRT) offers high precision and ablative dosing, minimizing toxicity to adjacent organs. This systematic review analyzed nine studies involving 426 patients and 809 lesions treated with SBRT. Patients had a median age of 61.2 years and underwent a median of three prior systemic treatments. SBRT, delivered at a median dose of 40 Gy, achieved a pooled median progression-free survival (PFS) of 10.32 months (95 % CI: 2.79-38.26) and a 2-year overall survival rate of 78 %. Local outcomes were promising, with a target lesion control rate of 95.9 % and a lesion response rate of 86 %. SBRT delayed systemic therapy initiation, with a median time of 9.45 months, and was well tolerated, with mostly mild toxicities (CTCAE grade ≤ 2). Rare grade 3 and 5 gastrointestinal toxicities were reported. Despite these encouraging results, the studies were limited by moderate to serious risk of bias, heterogeneity in treatment protocols, and variations in SBRT dose and fractionation. These findings highlight SBRT's potential as an effective treatment for oligometastatic ovarian cancer, but further research is needed to refine strategies, standardize regimens, and identify patient subgroups most likely to benefit. Prospective trials are eagerly awaited to establish SBRT's role in improving outcomes for this challenging clinical scenario.
管理疾病负担有限的复发性寡转移卵巢癌具有挑战性，需要进行局部治疗以实现持久控制，同时减少全身治疗的暴露。立体定向体部放疗（SBRT）提供高精度和消融剂量，将对相邻器官的毒性降至最低。本系统评价分析了9项研究，涉及426例患者和809个接受SBRT治疗的病灶。患者的中位年龄为61.2岁，之前接受全身治疗的中位次数为3次。SBRT的中位剂量为40Gy，汇总的中位无进展生存期（PFS）为10.32个月（95%CI：2.79-38.26），2年总生存率为78%。局部治疗效果良好，靶病灶控制率为95.9%，病灶缓解率为86%。SBRT延迟了全身治疗的开始，中位时间为9.45个月，耐受性良好，大多为轻度毒性（CTCAE分级≤2级）。报告了罕见的3级和5级胃肠道毒性。尽管有这些令人鼓舞的结果，但这些研究存在中度至严重的偏倚风险、治疗方案的异质性以及SBRT剂量和分割方式的差异。这些发现凸显了SBRT作为寡转移卵巢癌有效治疗方法的潜力，但需要进一步研究来完善策略、规范方案，并确定最可能受益的患者亚组。期待开展前瞻性试验以确定SBRT在改善这一具有挑战性的临床情况中的疗效方面的作用。
