PD-109 Stereotactic body radiation therapy for lung metastases: Impact on overall survival

Background: Radio-frequency ablation (RFA) and Stereotactic Body Radiation Therapy (SBRT) are two emerging therapies for lung metastases. Introduction: We performed a literature review to evaluate outcomes and complications of these procedures in patients with lung metastases from soft tissue sarcoma (STS). Method: After selection, seven studies were included for each treatment encompassing a total of 424 patients: 218 in the SBRT group and 206 in the RFA group. Results: The mean age ranged from 47.9 to 64 years in the SBRT group and from 48 to 62.7 years in the RFA group. The most common histologic subtype was, in both groups, leiomyosarcoma. : In the SBRT group, median overall survival ranged from 25.2 to 69 months and median disease-free interval from 8.4 to 45 months. Two out of seven studies reported G3 and one G3 toxicity, respectively. In RFA patients, overall survival ranged from 15 to 50 months. The most frequent complication was pneumothorax. : Local control showed high percentage for both procedures. Conclusion: SBRT is recommended in patients unsuitable to surgery, in synchronous bilateral pulmonary metastases, in case of deep lesions and in patients receiving high-risk systemic therapies. RFA is indicated in case of a long disease-free interval, in oligometastatic disease, when only the lung is involved, in small size lesions far from large vessels. : Further large randomized studies are necessary to establish whether these treatments may also represent a reliable alternative to surgery.

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1420 POSTER Stereotactic body radiation therapy for lung metastases: impact on overall survival

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(05)81711-2 ◽

2005 ◽

Vol 3 (2) ◽

pp. 411

Keyword(s):

Overall Survival ◽

Radiation Therapy ◽

Stereotactic Body Radiation Therapy ◽

Lung Metastases ◽

Stereotactic Body Radiation

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Role of stereotactic body radiation therapy for lung metastases from radio-resistant primary tumours

Journal of Cancer Research and Clinical Oncology ◽

10.1007/s00432-017-2373-y ◽

2017 ◽

Vol 143 (7) ◽

pp. 1293-1299 ◽

Cited By ~ 12

Author(s):

Davide Franceschini ◽

Luca Cozzi ◽

Fiorenza De Rose ◽

Piera Navarria ◽

Ciro Franzese ◽

...

Keyword(s):

Radiation Therapy ◽

Stereotactic Body Radiation Therapy ◽

Lung Metastases ◽

Stereotactic Body Radiation

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Excessive Toxicity When Treating Central Tumors in a Phase II Study of Stereotactic Body Radiation Therapy for Medically Inoperable Early-Stage Lung Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.07.5937 ◽

2006 ◽

Vol 24 (30) ◽

pp. 4833-4839 ◽

Cited By ~ 940

Author(s):

Robert Timmerman ◽

Ronald McGarry ◽

Constantin Yiannoutsos ◽

Lech Papiez ◽

Kathy Tudor ◽

...

Keyword(s):

Lung Cancer ◽

Overall Survival ◽

Radiation Therapy ◽

Phase Ii ◽

Local Control ◽

Stereotactic Body Radiation Therapy ◽

Early Stage ◽

Stage I ◽

Severe Toxicity ◽

Stereotactic Body Radiation

PurposeSurgical resection is standard therapy in stage I non–small-cell lung cancer (NSCLC); however, many patients are inoperable due to comorbid diseases. Building on a previously reported phase I trial, we carried out a prospective phase II trial using stereotactic body radiation therapy (SBRT) in this population.Patients and MethodsEligible patients included clinically staged T1 or T2 (≤ 7 cm), N0, M0, biopsy-confirmed NSCLC. All patients had comorbid medical problems that precluded lobectomy. SBRT treatment dose was 60 to 66 Gy total in three fractions during 1 to 2 weeks.ResultsAll 70 patients enrolled completed therapy as planned and median follow-up was 17.5 months. The 3-month major response rate was 60%. Kaplan-Meier local control at 2 years was 95%. Altogether, 28 patients have died as a result of cancer (n = 5), treatment (n = 6), or comorbid illnesses (n = 17). Median overall survival was 32.6 months and 2-year overall survival was 54.7%. Grade 3 to 5 toxicity occurred in a total of 14 patients. Among patients experiencing toxicity, the median time to observation was 10.5 months. Patients treated for tumors in the peripheral lung had 2-year freedom from severe toxicity of 83% compared with only 54% for patients with central tumors.ConclusionHigh rates of local control are achieved with this SBRT regimen in medically inoperable patients with stage I NSCLC. Both local recurrence and toxicity occur late after this treatment. This regimen should not be used for patients with tumors near the central airways due to excessive toxicity.

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