肝脏少见转移灶的立体定向放射治疗:根据estro/eortc共识建议进行的汇总分析。

IF 4.2 3区 医学 Q2 ONCOLOGY Clinical & Experimental Metastasis Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI:10.1007/s10585-024-10301-6
D Pezzulla, G Chiloiro, E M Lima, G Macchia, C Romano, S Reina, G Panza, S Cilla, A G Morganti, F Cellini, M A Gambacorta, F Deodato
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引用次数: 0

摘要

根据 ESTRO/EORTC 的建议,对立体定向放射治疗 (SBRT) 和放射外科手术 (SRS) 治疗的肝脏少见转移灶进行了大规模的汇总分析。从疗效和毒性方面分析了接受 SBRT/SRS 治疗的肝转移患者的临床和剂量数据。特别是分析了局部控制率(LC)、无远处转移生存率(DMFS)、无病生存率(DFS)、总生存率(OS)和下一次系统治疗无病生存率(NEST-FS)。对意大利两家放疗机构的113名患者(男/女:49/64)进行了评估,共涉及150个肝脏病灶(2006年3月至2023年2月)。中位年龄为 67 岁(36-92 岁),48 名患者(42.5%)至少患有一种并发症。大部分病灶为诱发转移(30.7%)或反复少进展转移(12.7%)。98个病灶接受了每天一次以上的分次治疗(主要是50 Gy分5次),52个病灶接受了放射外科治疗(主要是32 Gy)。147个病灶在3-4个月时的治疗反应可进行评估:完全反应占32.0%,部分反应占17.0%,疾病稳定占32.0%。1年的精算LC、DMFS、DFS、OS和NEST-FS分别为75.8%、37.7%、34.9%、78.7%和59.4%;2年的精算LC、DMFS、DFS、OS和NEST-FS分别为52.1%、24.9%、21.9%、51.3%和36.8%。获得完全反应、同步少转移灶和无治疗中断与更有利的结果相关。在毒性方面,只有两例急性和一例晚期毒性超过2级。就局部控制而言,立体定向治疗肝转移瘤似乎是一种安全且有前景的选择。完全反应、同步寡转移灶、组织学良好且未中断治疗的患者的疗效最佳。
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Stereotactic radiotherapy for liver oligometastases: a pooled analysis following the estro/eortc consensus recommendations.

A large pooled analysis of liver oligometastases, classified accordingly to the ESTRO/EORTC recommendations, treated by stereotactic radiotherapy (SBRT) and Radiosurgery (SRS) was carried out. The clinical and dosimetric data of patients who underwent SBRT/SRS for liver metastases were analysed in terms of efficacy and toxicity profile. In particular, the Local Control (LC), the Distant Metastases Free Survival (DMFS), the Disease-Free Survival (DFS), the Overall Survival (OS), and the Next Systemic Therapy Free Survival (NEST-FS) rates were analysed. 113 patients (M/F: 49/64), accounting for a total of 150 hepatic lesions (March 2006-February 2023) in two Italian radiotherapy Institutions were evaluated. Median age was 67 years old (36-92) and 48 (42.5%) patients had at least one comorbidity. The majority of the lesions were induced (30.7%) or repeated oligoprogressive (12.7%) metastases. 98 lesions were treated with more than one daily fraction (mainly 50 Gy in 5 fractions), while 52 were radiosurgery treatments (mainly 32 Gy). The treatment response at 3-4 months was evaluable in 147 lesions: complete response was 32.0%, partial response 17.0%, and stable disease 32.0%. Actuarial LC, DMFS, DFS, OS, and NEST-FS at 1 year were 75.8%, 37.7%, 34.9%, 78.7%, and 59.4% respectively; while actuarial LC, DMFS, DFS, OS, and NEST-FS at 2 years were 52.1%, 24.9%, 21.9%, 51.3%, and 36.8%, respectively. The achievement of complete response, synchronous oligometastases, and no treatment interruptions correlated with a more favorable outcomes. As per the toxicity profile, we registered only two acute and one late toxicity cases higher than grade 2. Stereotactic treatment for liver metastases seems to be a safe and promising option in terms of local control. The best results in term of outcomes have been obtained in patients with complete response, synchronous oligometastases, favorable histology, and no treatment interruptions.

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来源期刊
CiteScore
7.80
自引率
5.00%
发文量
55
审稿时长
12 months
期刊介绍: The Journal''s scope encompasses all aspects of metastasis research, whether laboratory-based, experimental or clinical and therapeutic. It covers such areas as molecular biology, pharmacology, tumor biology, and clinical cancer treatment (with all its subdivisions of surgery, chemotherapy and radio-therapy as well as pathology and epidemiology) insofar as these disciplines are concerned with the Journal''s core subject of metastasis formation, prevention and treatment.
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