The role of stereotactic body radiation therapy in the management of pulmonary metastases: a systematic review

Abstract

While pulmonary metastases are often managed through metastasectomies, stereotactic body radiation therapy (SBRT) is a relatively novel treatment that has shown promise for this disease. This review aimed to summarize the current findings of SBRT in the treatment of pulmonary metastases. MEDLINE, EMBASE, and CENTRAL were searched for articles that examined the use of SBRT for patients with pulmonary metastases. Primary outcomes included overall survival, disease‐free survival, and progression‐free survival. Results were pooled where appropriate. Risk of bias was assessed through the Methodological Index for Non‐Randomized Studies tool. After screening, 13 studies with 545 patients conducted between 2006 and 2020 were included in this review. Primary tumor localizations included gastrointestinal, pulmonary, and bone, among others. Pooled overall survival at 1 year was 81%, 41% at 3 years, 34% at 4 years, and 26% at 5 years. Pooled progression‐free survival at 1, 2, and 3 years was 60%, 41%, and 31% respectively. Local control at 1, 2, and 3 years were 90%, 79%, and 77%, respectively. Preliminary evidence regarding SBRT for treatment of pulmonary metastases shows promising benefits for overall survival and local control. Further high‐quality prospective trials are required to investigate the effectiveness and treatment‐related adverse effects of SBRT, and should compare it with metastasectomy.