Additional chemotherapy improved local control and overall survival after stereotactic body radiation therapy for patients with oligo-recurrence.
Additional chemotherapy improved local control and overall survival after stereotactic body radiation therapy for patients with oligo-recurrence.
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DOI：
10.1186/s13014-018-1031-0
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发表时间：
2018-04-23
期刊：
影响因子：
--
通讯作者：
Nishimura H
中科院分区：
文献类型：
--
作者：
Nakamura M;Hashimoto N;Mayahara H;Uezono H;Harada A;Nishikawa R;Matsuo Y;Kawaguchi H;Nishimura H
与其他寡转移性疾病相比，寡转移复发被认为可改善预后，立体定向体部放射治疗（SBRT）被认为是肺或肝转移的局部治疗选择。本研究的目的是探讨SBRT治疗肺和肝少复发性病变的有效性和安全性，并评估局部控制和预后的预测因素。这项回顾性研究纳入了2013年5月至2016年3月在一家机构接受SBRT治疗的1-3例异时性肺或肝转移的患者。所有患者的原发病变均得到控制。排除随访时间< 6个月的患者。根据Kaplan-Meier乘积限法分析局部控制、无进展生存期和总生存率。进行单变量对数秩和多变量考克斯回归分析，以阐明局部控制和预后的预测因素。根据不良事件通用术语标准（版本4.0）对毒性进行分级。纳入了76例患者，共70处和44处肺部和肝脏病变。中位随访期为21个月（范围：7-43）。1年局部控制率、无进展生存率和总生存率分别为89%、38%和96%。SBRT后较小的大体肿瘤体积和额外的化疗是更好的局部控制的重要预测因素（p = 0.005和p = 0.047），并且单个转移病灶的存在是良好的无进展生存期的重要因素（p = 0.008）。SBRT后的额外化疗不是一个显著的预测因素，但可提高总生存率（p = 0.078）。在结直肠癌患者中，SBRT化疗后与更好的OS显著相关（p = 0.025）。3级以上不良事件仅见于1例患者。SBRT是一种安全有效的治疗肺和肝少复发的患者。SBRT后的额外化疗改善了局部控制，在本研究中，单个转移病灶是PFS较好的重要预测因素。在结直肠癌患者中，SBRT后额外化疗与更好的OS显著相关。
Oligo-recurrence has been considered to confer improved prognosis than other oligometastatic conditions, and stereotactic body radiation therapy (SBRT) is considered as an option of local therapy for lung or liver metastases. The purpose of this study was to investigate the efficacy and safety of SBRT for lung and liver oligo-recurrent lesions and evaluate predictive factors for local control and prognosis. This retrospective study included patients who presented with 1–3 matachronous lung or liver metastases, and treated with SBRT between May 2013 and March 2016 at a single institution. All patients harbored a controlled primary lesion. Patients with < 6 months of follow-up were excluded. Local control, progression free survival, and overall survival rates were analyzed according to the Kaplan–Meier product limit method. Univariable log-rank and multivariable Cox regression analyses were performed to clarify predictive factors for local control and prognosis. Toxicity was graded according to the Common Terminology Criteria for Adverse Events, version 4.0. Seventy-six patients with a total of 70 and 44 lung and liver lesions were included. The median follow-up period was 21 (range, 7–43) months. The 1-year local control, progression-free survival and overall survival rates were 89, 38 and 96%, respectively. Smaller gross tumor volume and additional chemotherapy after SBRT were significant predictive factors for better local control (p = 0.005 and p = 0.047), and the presence of a single metastatic lesion was a significant factor of good progression free survival (p = 0.008). Additional chemotherapy after SBRT was not a significant predictive factor but conferred to better overall survival (p = 0.078). Among colorectal cancer patients, post SBRT chemotherapy was significantly associated with better OS (p = 0.025). Over grade 3 adverse event was seen in only one patient. SBRT is a safe and effective treatment for patients with lung and liver oligo-recurrence. Additional chemotherapy after SBRT improved local control, and single metastatic lesion was a significant predictive factor of better PFS in this study. Among colorectal cancer patients, additional chemotherapy after SBRT significantly associated better OS.
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结肠癌初选和使用分子测定的转移酶之间的差异对肿瘤辐射敏感性表明对潜在的寡量转移SBRT患者选择的影响。
DOI：
10.1016/j.ijrobp.2015.01.036
发表时间：
2015-07-15
影响因子：
7
作者：
Ahmed, Kamran A.;Fulp, William J.;Berglund, Anders E.;Hoffe, Sarah E.;Dilling, Thomas J.;Eschrich, Steven A.;Shridhar, Ravi;Torres-Roca, Javier F.
通讯作者：
Torres-Roca, Javier F.
影响因子：
10.9
作者：
Lipson EJ;Velculescu VE;Pritchard TS;Sausen M;Pardoll DM;Topalian SL;Diaz LA Jr
通讯作者：
Diaz LA Jr
DOI：
10.1016/j.ijrobp.2014.10.046
发表时间：
2015-03-01
影响因子：
7
作者：
Filippi, Andrea Riccardo;Badellino, Serena;Ricardi, Umberto
通讯作者：
Ricardi, Umberto
DOI：
10.1016/j.ijrobp.2016.03.050
发表时间：
2016-08-01
影响因子：
7
作者：
Ahmed, Kamran A.;Caudell, Jimmy J.;Torres-Roca, Javier F.
通讯作者：
Torres-Roca, Javier F.
影响因子：
5.7
作者：
Klement, R. J.;Guckenberger, M.;Andratschke, N.
通讯作者：
Andratschke, N.