Katano Atsuto, Minamitani Masanari, Ohira Shingo, Sawayanagi Subaru, Yamashita Hideomi
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan.
Department of Radiological Science, Faculty of Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
Cancer Rep (Hoboken). 2025 Jun;8(6):e70248. doi: 10.1002/cnr2.70248.
Oligometastatic disease, characterized by a limited number of metastatic lesions, has gained significant attention for its potential to enable long-term survival with definitive local therapies. Esophageal cancer, an aggressive malignancy often diagnosed at advanced stages, carries a poor prognosis, particularly in cases involving distant metastasis. Stereotactic body radiation therapy (SBRT) has emerged as a promising local treatment modality for oligometastatic disease, offering precise high-dose radiation delivery. This study evaluated the outcomes of SBRT in patients with oligometastatic esophageal cancer.
This retrospective study analyzed 33 patients with esophageal cancer who underwent SBRT for all oligometastatic lesions at a single institution between August 2014 and March 2024. The inclusion criteria were patients with squamous cell carcinoma, extracranial oligometastases, and no concurrent systemic therapy. Oligometastatic diseases were categorized into de novo, repeat, and induced subtypes. Survival outcomes, including overall survival (OS) and progression-free survival (PFS), were assessed using the Kaplan-Meier method.
The study cohort included 33 patients with a median age of 68 years. Most patients had one treated lesion, with SBRT doses ranging from 25-50 Gy in 4-10 fractions. Median OS and PFS were 17.3 months and 4.2 months, respectively. Patients with locoregional recurrence exhibited longer median PFS (5.1 months) and OS (19.6 months) compared to those with distant metastases (PFS: 3.0 months; OS: 14.8 months). Stratification by oligometastatic subtype revealed the best outcomes in de novo cases, with a median OS of 19.6 months and PFS of 8.8 months. Local control at 1 year was 90.7% for the entire cohort, with limited severe late adverse events.
SBRT demonstrated promising outcomes in patients with oligometastatic esophageal cancer, offering high local control with minimal toxicity. Although these results highlight the feasibility of SBRT, larger prospective studies are needed to validate these findings.
寡转移疾病以转移病灶数量有限为特征，因其通过确定性局部治疗实现长期生存的潜力而备受关注。食管癌是一种侵袭性恶性肿瘤，常于晚期被诊断出来，预后较差，尤其是在发生远处转移的情况下。立体定向体部放疗（SBRT）已成为一种治疗寡转移疾病的有前景的局部治疗方式，可提供精确的高剂量放疗。本研究评估了SBRT治疗寡转移食管癌患者的疗效。
这项回顾性研究分析了2014年8月至2024年3月期间在单一机构对所有寡转移病灶接受SBRT治疗的33例食管癌患者。纳入标准为鳞状细胞癌、颅外寡转移且未同时接受全身治疗的患者。寡转移疾病分为初发、复发和诱导亚型。使用Kaplan-Meier方法评估生存结局，包括总生存期（OS）和无进展生存期（PFS）。
研究队列包括33例患者，中位年龄为68岁。大多数患者有一个接受治疗的病灶，SBRT剂量为25 - 50 Gy，分4 - 10次给予。中位OS和PFS分别为17.3个月和4.2个月。与远处转移患者相比，局部区域复发患者的中位PFS（5.1个月）和OS（19.6个月）更长（PFS：3.0个月；OS：14.8个月）。按寡转移亚型分层显示，初发病例的结局最佳，中位OS为19.6个月，PFS为8.8个月。整个队列1年时的局部控制率为90.7%，严重晚期不良事件有限。
SBRT在寡转移食管癌患者中显示出有前景的疗效，具有高局部控制率且毒性最小。尽管这些结果突出了SBRT的可行性，但需要更大规模的前瞻性研究来验证这些发现。
