Stereotactic body radiotherapy (SBRT) for medically inoperable lung metastases-A pooled analysis of the German working group "stereotactic radiotherapy".

Rieber, Juliane; Streblow, Jan; Uhlmann, Lorenz; Flentje, Michael; Duma, Marciana; Ernst, Iris; Blanck, Oliver; Wittig, Andrea; Boda-Heggemann, Judit; Krempien, Robert; Lohaus, Fabian; Klass, Natalie Désirée; Eble, Michael J; Imhoff, Detlef; Kahl, Henning; Petersen, Cordula; Gerum, Sabine; Henkenberens, Christoph; Adebahr, Sonja; Hass, Peter; ... (2016). Stereotactic body radiotherapy (SBRT) for medically inoperable lung metastases-A pooled analysis of the German working group "stereotactic radiotherapy". Lung cancer, 97, pp. 51-58. Elsevier 10.1016/j.lungcan.2016.04.012

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OBJECTIVES The current literature on stereotactic body radiotherapy (SBRT) for oligometastatic disease is characterized by small patient cohorts with heterogeneous primary tumors, metastases location and dose regimes. Hence, this study established a multi-institutional database of 700 patients treated with SBRT for pulmonary metastases to identify prognostic factors influencing survival and local control. MATERIALS AND METHODS All German radiotherapy departments were contacted and invited to participate in this analysis. A total number of 700 patients with medically inoperable lung metastases treated with SBRT in 20 centers between 1997 and 2014 were included in a database. Primary and metastatic tumor characteristics, treatment characteristics and follow-up data including survival, local control, distant metastases, and toxicity were evaluated. Lung metastases were treated with median PTV-encompassing single doses of 12.5Gy (range 3.0-33.0Gy) in a median number of 3 fractions (range 1-13). RESULTS After a median follow-up time of 14.3 months, 2-year local control (LC) and overall survival (OS) were 81.2% and 54.4%, respectively. In multivariate analysis, OS was most significantly influenced by pretreatment performance status, maximum metastasis diameter, primary tumor histology, time interval between primary tumor diagnosis and SBRT treatment and number of metastases. For LC, independent prognostic factors were pretreatment performance status, biological effective dose (BED) at PTV isocenter (BEDISO) and single fraction (PTV-encompassing) dose in multivariate analysis. Radiation-induced pneumonitis grade 2 or higher was observed in 6.5% of patients. The only factor significantly influencing toxicity was BEDISO (p=0.006). CONCLUSION SBRT for medically inoperable patients with pulmonary metastases achieved excellent local control and promising overall survival. Important prognostic factors were identified for selecting patients who might benefit most from this therapy approach.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Klass, Natalie Désirée

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0169-5002

Publisher:

Elsevier

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

07 Apr 2017 14:33

Last Modified:

07 Apr 2017 14:33

Publisher DOI:

10.1016/j.lungcan.2016.04.012

PubMed ID:

27237028

Uncontrolled Keywords:

Extracranial stereotactic radiotherapy; Lung metastases; Oligometastases; Pulmonary SBRT; Radiosurgery; Stereotactic body radiotherapy

BORIS DOI:

10.7892/boris.92807

URI:

https://boris.unibe.ch/id/eprint/92807

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