Analyses of the local control of pulmonary Oligometastases after stereotactic body radiotherapy and the impact of local
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RESEARCH ARTICLE
Open Access
Analyses of the local control of pulmonary Oligometastases after stereotactic body radiotherapy and the impact of local control on survival Takaya Yamamoto1* , Yuzuru Niibe2,3, Masahiko Aoki4, Takashi Shintani5, Kazunari Yamada6, Mitsuru Kobayashi7, Hideomi Yamashita8, Masatoki Ozaki9, Yoshihiko Manabe10, Hiroshi Onishi11, Katsuya Yahara12, Atsushi Nishikawa13, Kuniaki Katsui14, Ryoong-Jin Oh15, Atsuro Terahara2 and Keiichi Jingu1
Abstract Background: Successful local therapy for oligometastases may lead to longer survival. The purpose of this multicentre retrospective study was to investigate factors affecting the local control (LC) of pulmonary oligometastases treated by stereotactic body radiotherapy (SBRT) and to investigate the impact of LC on survival. Methods: The inclusion criteria included 1 to 5 metastases, the primary lesion and other extrathoracic metastases were controlled before SBRT, and the biological effective dose (BED10) of the SBRT was 75 Gy or more. The Cox proportional hazards model was used for analyses. Results: Data of 1378 patients with 1547 tumours from 68 institutions were analysed. The median follow-up period was 24.2 months. The one-year, 3-year and 5-year LC rates were 92.1, 81.3 and 78.6%, respectively, and the 1-year, 3year and 5-year overall survival rates were 90.1, 60.3 and 45.5%, respectively. Multivariate analysis for LC showed that increased maximum tumour diameter (p = 0.011), type A dose calculation algorithm (p = 0.005), shorter overall treatment time of SBRT (p = 0.035) and colorectal primary origin (p < 0.001 excluding oesophagus origin) were significantly associated with a lower LC rate. In the survival analysis, local failure (p < 0.001), worse performance status (1 vs. 0, p = 0.013; 2–3 vs. 0, p < 0.001), oesophageal primary origin (vs. colorectal origin, p = 0.038), squamous cell carcinoma (vs. adenocarcinoma, p = 0.006) and increased maximum tumour diameter (p < 0.001) showed significant relationships with shorter survival. Conclusions: Several factors of oligometastases and SBRT affected LC. LC of pulmonary oligometastases by SBRT showed a significant survival benefit compared to patients with local failure. Keywords: Pulmonary oligometastases, Oligo-recurrence, Sync-oligometastases, Stereotactic body radiotherapy, Local control, Metastasis-directed therapy
* Correspondence: [email protected] 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this arti
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