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. 2020 Oct 14;20(1):997.
doi: 10.1186/s12885-020-07514-9.

Analyses of the local control of pulmonary Oligometastases after stereotactic body radiotherapy and the impact of local control on survival

Takaya Yamamoto  1 , Yuzuru Niibe  2   3 , Masahiko Aoki  4 , Takashi Shintani  5 , Kazunari Yamada  6 , Mitsuru Kobayashi  7 , Hideomi Yamashita  8 , Masatoki Ozaki  9 , Yoshihiko Manabe  10 , Hiroshi Onishi  11 , Katsuya Yahara  12 , Atsushi Nishikawa  13 , Kuniaki Katsui  14 , Ryoong-Jin Oh  15 , Atsuro Terahara  2 , Keiichi Jingu  16
Affiliations

Analyses of the local control of pulmonary Oligometastases after stereotactic body radiotherapy and the impact of local control on survival

Takaya Yamamoto et al. BMC Cancer. .

Abstract

Background: Successful local therapy for oligometastases may lead to longer survival. The purpose of this multicentre retrospective study was to investigate factors affecting the local control (LC) of pulmonary oligometastases treated by stereotactic body radiotherapy (SBRT) and to investigate the impact of LC on survival.

Methods: The inclusion criteria included 1 to 5 metastases, the primary lesion and other extrathoracic metastases were controlled before SBRT, and the biological effective dose (BED10) of the SBRT was 75 Gy or more. The Cox proportional hazards model was used for analyses.

Results: Data of 1378 patients with 1547 tumours from 68 institutions were analysed. The median follow-up period was 24.2 months. The one-year, 3-year and 5-year LC rates were 92.1, 81.3 and 78.6%, respectively, and the 1-year, 3-year and 5-year overall survival rates were 90.1, 60.3 and 45.5%, respectively. Multivariate analysis for LC showed that increased maximum tumour diameter (p = 0.011), type A dose calculation algorithm (p = 0.005), shorter overall treatment time of SBRT (p = 0.035) and colorectal primary origin (p < 0.001 excluding oesophagus origin) were significantly associated with a lower LC rate. In the survival analysis, local failure (p < 0.001), worse performance status (1 vs. 0, p = 0.013; 2-3 vs. 0, p < 0.001), oesophageal primary origin (vs. colorectal origin, p = 0.038), squamous cell carcinoma (vs. adenocarcinoma, p = 0.006) and increased maximum tumour diameter (p < 0.001) showed significant relationships with shorter survival.

Conclusions: Several factors of oligometastases and SBRT affected LC. LC of pulmonary oligometastases by SBRT showed a significant survival benefit compared to patients with local failure.

Keywords: Local control; Metastasis-directed therapy; Oligo-recurrence; Pulmonary oligometastases; Stereotactic body radiotherapy; Sync-oligometastases.

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Conflict of interest statement

YN has received lecturer fees from Janssen Pharmaceutical K.K.

TY, MA, TS, KY1, MK, HY, MO, YM, HO, KY2, AN, KK, RO, AT and KJ declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan-Meier local control (LC) curve and overall survival (OS) curve. The results of the Kaplan-Meier LC curves and OS curves are shown. Because of the missing values, 1374 patients with 1489 tumours were used for the estimate
Fig. 2
Fig. 2
Kaplan-Meier local control curves according to the primary lesion: colorectal oligometastasis and other (non-colorectal) oligometastasis. Local control of pulmonary oligometastases from the colorectum was far worse than that of pulmonary oligometastases of non-colorectal origin
Fig. 3
Fig. 3
Landmark analyses for OS to compare between a locally controlled cohort and a locally failed cohort. All the local failures after the landmark time and all the deaths before that time were ignored. The locally controlled group showed a consistent significantly longer survival than the locally failed group at each landmark time
See this image and copyright information in PMC

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