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Review
. 2022 May 11;14(10):2373.
doi: 10.3390/cancers14102373.

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Nicola Longo  1 , Giuseppe Celentano  1 , Luigi Napolitano  1 , Roberto La Rocca  1 , Marco Capece  1 , Gianluigi Califano  1 , Claudia Collà Ruvolo  1 , Francesco Mangiapia  1 , Ferdinando Fusco  2 , Simone Morra  1 , Carmine Turco  1 , Francesco Di Bello  1 , Giovanni Maria Fusco  1 , Luigi Cirillo  1 , Crescenzo Cacciapuoti  1 , Lorenzo Spirito  2 , Armando Calogero  3 , Antonello Sica  4 , Caterina Sagnelli  5 , Massimiliano Creta  1
Affiliations
Review

Metastasis-Directed Radiation Therapy with Consolidative Intent for Oligometastatic Urothelial Carcinoma: A Systematic Review and Meta-Analysis

Nicola Longo et al. Cancers (Basel). .

Abstract

The management of patients with oligometastatic urothelial carcinoma (UC) represents an evolving field in uro-oncology, and the role of metastasis-directed therapies, including metastasectomy and metastasis-directed radiation therapy (MDRT), is gaining increasing attention. Herein, we summarize available evidence about the role of MDRT with consolidative intent in oligometastatic UC patients. A systematic review was performed in December 2021. Six studies involving 158 patients were identified. Most patients (n = 120, 90.2%) had a history of bladder cancer and the most frequent sites of metastases were lymph nodes (n = 61, 52.1%) followed by the lungs (n = 34, 29%). Overall, 144 metastases were treated with MDRT. Median follow-up ranged from 17.2 to 25 months. Local control rates ranged from 57% to 100%. Median Overall Survival (OS) ranged from 14.9 to 51.0 months and median progression-free survival ranged from 2.9 to 10.1 months. Rates of OS at one and two years ranged from 78.9% to 96% and from 26% to 63%, respectively. Treatment-related toxicity was recorded in few patients and in most cases a low-grade toxicity was evident. MDRT with consolidative intent represents a potential treatment option for selected patients with oligometastatic UC.

Keywords: bladder cancer; oligometastatic disease; radiotherapy; upper urinary transitional cell carcinoma; urothelial carcinoma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the systematic review.
Figure 2
Figure 2
Forest plot showing the event rate for Overall Response Rate. ES, effect size; CI, confidence interval. (I2 = 0.00, p = 0.368.)
Figure 3
Figure 3
Forest plot showing the event rate for 2-year progression-free survival. ES, effect size; CI, confidence interval. (I2 = 25.39, p = 0.262.)
Figure 4
Figure 4
Forest plot showing the event rate for 2-year overall survival. ES, effect size; CI, confidence interval. (I2 = 42.91, p = 0.154.)
Figure 5
Figure 5
Funnel plots of the meta-analysis evaluating the event rate for 2-year progression-free survival. Egger’s linear regression (t= −28.93, p = 0.022) and Begg and Mazumdar’s rank correlation test (z = −1.57, p = 0.117).
Figure 6
Figure 6
Funnel plots of the meta-analysis evaluating the event rate for 2-year overall survival. Egger’s linear regression (t= −0.47, p = 0.683) and Begg and Mazumdar’s rank correlation test (z = −0.68, p = 0.497).
Figure 7
Figure 7
Funnel plots of the meta-analysis evaluating the event rate for Overall Response Rate. Egger’s linear regression (t = −0.98, p = 0.505) and Begg and Mazumdar’s rank correlation test (z = −0.52, p = 0.602).
See this image and copyright information in PMC

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