Radiosensitivity Differences Between Liver Metastases Based on Primary Histology Suggest Implications for Clinical Outcomes After Stereotactic Body Radiation Therapy
Radiosensitivity Differences Between Liver Metastases Based on Primary Histology Suggest Implications for Clinical Outcomes After Stereotactic Body Radiation Therapy
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DOI：
10.1016/j.ijrobp.2016.03.050
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发表时间：
2016-08-01
影响因子：
7
通讯作者：
Torres-Roca, Javier F.
中科院分区：
文献类型：
--
作者：
Ahmed, Kamran A.;Caudell, Jimmy J.;Torres-Roca, Javier F.
目的/目的：立体定向全身放射治疗(SBRT)治疗寡转移瘤的证据表明，基于初级组织学的结果存在差异。我们先前在多个独立队列中确认了肿瘤放射敏感性(RSI)的多基因表达指数。在这项研究中，我们评估了肝转移瘤的RSI，并基于基本的组织学评估了SBRT后的临床结果。方法和材料：根据我们的前瞻性观察方案确定患者。先前测试的RSI 10基因测试在样本上运行，并使用已发表的算法进行计算。结果：从我们的前瞻性机构元数据池中确定了372个独特的转移性肝病变。肝转移最常见的原发组织是结直肠癌(n=314，84.4%)、乳腺癌(n=12，3.2%)和胰腺神经内分泌(n=11，3%)。肝转移瘤的RSI在组织学基础上有显著差异。肝转移的放射抵抗中位数依次为胃肠道间质瘤(0.57)、黑色素瘤(0.53)、结直肠神经内分泌(0.46)、胰腺神经内分泌(0.44)、结直肠癌(0.43)、乳腺癌(0.35)、肺腺癌(0.31)、胰腺癌(0.27)、肛门鳞癌(0.22)、小肠神经内分泌(0.21)(P<；0001)。来自独立临床队列的大肠病变12个月和24个月的Kaplan-Meier局部控制率(LC)分别为79%和59%，而非大肠病变的局控率分别为100%(P=.019)。结论：在这项分析中，我们发现了基于初级组织学的显著差异。这项研究表明，初级组织学可能是选择SBRT照射剂量时考虑的一个重要因素。(C)2016 Elsevier Inc.保留所有权利。
Purpose/Objectives: Evidence from the management of oligometastases with stereotactic body radiation therapy (SBRT) reveals differences in outcomes based on primary histology. We have previously identified a multigene expression index for tumor radiosensitivity (RSI) with validation in multiple independent cohorts. In this study, we assessed RSI in liver metastases and assessed our clinical outcomes after SBRT based on primary histology.Methods and Materials: Patients were identified from our prospective, observational protocol. The previously tested RSI 10 gene assay was run on samples and calculated using the published algorithm. An independent cohort of 33 patients with 38 liver metastases treated with SBRT was used for clinical correlation.Results: A total of 372 unique metastatic liver lesions were identified for inclusion from our prospective, institutional metadata pool. The most common primary histologies for liver metastases were colorectal adenocarcinoma (n = 314, 84.4%), breast adenocarcinoma (n = 12, 3.2%), and pancreas neuroendocrine (n = 11, 3%). There were significant differences in RSI of liver metastases based on histology. The median RSIs for liver metastases in descending order of radioresistance were gastrointestinal stromal tumor (0.57), melanoma (0.53), colorectal neuroendocrine (0.46), pancreas neuroendocrine (0.44), colorectal adenocarcinoma (0.43), breast adenocarcinoma (0.35), lung adenocarcinoma (0.31), pancreas adenocarcinoma (0.27), anal squamous cell cancer (0.22), and small intestine neuroendocrine (0.21) (P < . 0001). The 12-month and 24-month Kaplan-Meier rates of local control (LC) for colorectal lesions from the independent clinical cohort were 79% and 59%, compared with 100% for non-colorectal lesions (P = .019), respectively.Conclusions: In this analysis, we found significant differences based on primary histology. This study suggests that primary histology may be an important factor to consider in SBRT radiation dose selection. (C) 2016 Elsevier Inc. All rights reserved.