Long-term Follow-up and Patterns of Recurrence of Patients With Oligometastatic NSCLC Treated With Pulmonary SBRT
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Long-term Follow-up and Patterns of Recurrence of Patients With Oligometastatic NSCLC Treated With Pulmonary SBRT. / Hörner-Rieber, Juliane; Bernhardt, Denise; Blanck, Oliver; Duma, Marciana; Eich, Hans Th; Gerum, Sabine; Gkika, Eleni; Hass, Peter; Henkenberens, Christoph; Herold, Hans-Ulrich; Hildebrandt, Guido; Imhoff, Detlef; Kahl, Henning; Janssen, Stefan; Jurianz, Katrin; Krempien, Robert; Lautenschläger, Stefan Friedrich; Lohaus, Fabian; Mueller, Arndt-Christian; Petersen, Cordula; Sackerer, Irina; Scafa, Davide; Schrade, Elsge; Uhlmann, Lorenz; Wittig, Andrea; Guckenberger, Matthias.
In: CLIN LUNG CANCER, Vol. 20, No. 6, 11.2019, p. e667-e677.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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T1 - Long-term Follow-up and Patterns of Recurrence of Patients With Oligometastatic NSCLC Treated With Pulmonary SBRT
AU - Hörner-Rieber, Juliane
AU - Bernhardt, Denise
AU - Blanck, Oliver
AU - Duma, Marciana
AU - Eich, Hans Th
AU - Gerum, Sabine
AU - Gkika, Eleni
AU - Hass, Peter
AU - Henkenberens, Christoph
AU - Herold, Hans-Ulrich
AU - Hildebrandt, Guido
AU - Imhoff, Detlef
AU - Kahl, Henning
AU - Janssen, Stefan
AU - Jurianz, Katrin
AU - Krempien, Robert
AU - Lautenschläger, Stefan Friedrich
AU - Lohaus, Fabian
AU - Mueller, Arndt-Christian
AU - Petersen, Cordula
AU - Sackerer, Irina
AU - Scafa, Davide
AU - Schrade, Elsge
AU - Uhlmann, Lorenz
AU - Wittig, Andrea
AU - Guckenberger, Matthias
N1 - Copyright © 2019 Elsevier Inc. All rights reserved.
PY - 2019/11
Y1 - 2019/11
N2 - INTRODUCTION: This multicenter study aims to analyze outcome as well as early versus late patterns of recurrence following pulmonary stereotactic body radiotherapy (SBRT) for patients with oligometastatic non-small-cell lung cancer (NSCLC).MATERIALS AND METHODS: This analysis included 301 patients with oligometastatic NSCLC treated with SBRT for 336 lung metastases. Although treatment of the primary tumor consisted of surgical resection, radiochemotherapy, and/or systemic therapy, pulmonary oligometastases were treated with SBRT.RESULTS: The median follow-up time was 16.1 months, resulting in 2-year overall survival (OS), local control (LC), and distant control (DC) of 62.2%, 82.0%, and 45.2%, respectively. Multivariate analysis identified age (P = .019) and histologic subtype (P = .028), as well as number of metastatic organs (P < .001) as independent prognostic factors for OS. LC was superior for patients with favorable histologic subtype (P = .046) and SBRT with a higher biological effective dose at isocenter (P = .037), whereas DC was inferior for patients with metastases in multiple organs (P < .001) and female gender (P = .027). Early (within 24 months) local or distant progression was observed in 15.3% and 36.5% of the patients. After 24 months, the risk of late local failure was low, with 3- and 4-year local failure rates of only 4.0%, and 7.6%. In contrast, patients remained at a high risk of distant progression with 3- and 4-year failure rates of 13.3% and 24.1%, respectively, with no plateau observed.CONCLUSION: SBRT for pulmonary oligometastatic NSCLC resulted in favorable LC and promising OS. The dominant failure pattern is distant with a continuously high risk of disease progression for many years.
AB - INTRODUCTION: This multicenter study aims to analyze outcome as well as early versus late patterns of recurrence following pulmonary stereotactic body radiotherapy (SBRT) for patients with oligometastatic non-small-cell lung cancer (NSCLC).MATERIALS AND METHODS: This analysis included 301 patients with oligometastatic NSCLC treated with SBRT for 336 lung metastases. Although treatment of the primary tumor consisted of surgical resection, radiochemotherapy, and/or systemic therapy, pulmonary oligometastases were treated with SBRT.RESULTS: The median follow-up time was 16.1 months, resulting in 2-year overall survival (OS), local control (LC), and distant control (DC) of 62.2%, 82.0%, and 45.2%, respectively. Multivariate analysis identified age (P = .019) and histologic subtype (P = .028), as well as number of metastatic organs (P < .001) as independent prognostic factors for OS. LC was superior for patients with favorable histologic subtype (P = .046) and SBRT with a higher biological effective dose at isocenter (P = .037), whereas DC was inferior for patients with metastases in multiple organs (P < .001) and female gender (P = .027). Early (within 24 months) local or distant progression was observed in 15.3% and 36.5% of the patients. After 24 months, the risk of late local failure was low, with 3- and 4-year local failure rates of only 4.0%, and 7.6%. In contrast, patients remained at a high risk of distant progression with 3- and 4-year failure rates of 13.3% and 24.1%, respectively, with no plateau observed.CONCLUSION: SBRT for pulmonary oligometastatic NSCLC resulted in favorable LC and promising OS. The dominant failure pattern is distant with a continuously high risk of disease progression for many years.
U2 - 10.1016/j.cllc.2019.06.024
DO - 10.1016/j.cllc.2019.06.024
M3 - SCORING: Journal article
C2 - 31327644
VL - 20
SP - e667-e677
JO - CLIN LUNG CANCER
JF - CLIN LUNG CANCER
SN - 1525-7304
IS - 6
ER -