Role of Radiosurgery and Stereotactic Ablative Radiotherapy for Oligometastatic Non-Oncogene Addicted NSCLC
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design, Patient Population
2.2. Outcomes/Endpoints
2.3. Treatment Details
2.4. Response Assessment and Follow-Up
2.5. Statistical Analyses
3. Results
3.1. Population Characteristics
3.2. Treatment Characteristics
3.3. Clinical Outcomes
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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All Patients, n = 245 No. (%) | |
---|---|
Gender | |
Male | 174 (71) |
Female | 71 (29) |
Age (years) | |
<70 | 125 (51) |
≥70 | 120 (49) |
ECOG PS | |
0 | 166 (68) |
1 | 79 (32) |
Histology | |
Adenocarcinoma | 181 (74) |
Squamous Cell | 34 (14) |
Other | 16 (6) |
NSCLC Unknown/Not specified | 14 (6) |
PD-L1 | |
0% | 21 (8) |
>1% | 15 (6) |
>50% | 14 (6) |
Unknown | 195 (80) |
Stage at NSCLC diagnosis | |
Early | 65 (27) |
Locally Advanced | 106 (43) |
Metastatic | 74 (30) |
N stage at NSCLC diagnosis | |
0 | 114 (47) |
1 | 39 (16) |
2 | 66 (27) |
3 | 20 (8) |
Unknown | 6 (2) |
Type of OMD | |
Synchronous | 53 (22) |
Oligorecurrent | 165 (67) |
Oligoprogressive | 27 (11) |
Lesion(s) at OMD diagnosis | |
1 | 154 (63) |
2 | 63 (25) |
3 | 19 (8) |
4 | 4 (2) |
5 | 5 (2) |
No. of involved organ(s) at OMD diagnosis | |
1 | 218 (89) |
2 | 25 (10) |
3–4 | 2 (1) |
Type of involved organ(s) at OMD diagnosis | |
Lung | 102 (41) |
Brain | 108 (44) |
Bone | 4 (2) |
Adrenal | 5 (2) |
Multiple organs with brain a | 21 (9) |
Multiple organs extra brain b | 5 (2) |
Treatment Characteristics | All Patients, n = 245 |
---|---|
No. (%) | |
Treatment at NSCLC diagnosis | |
Surgery alone | 71 (29) |
SABR | 30 (12) |
CT + RT | 24 (10) |
Systemic therapy alone | 55 (22) |
Surgery + adjuvant therapy | 60 (25) |
Other treatment | 5 (2) |
Systemic therapy at NSCLC diagnosis | |
CT | 129 (53) |
IT | 3 (1) |
CT + IT | 2 (1) |
None | 111 (45) |
Response after NSCLC treatment | |
CR | 97 (40) |
PR | 91 (37) |
SD | 36 (15) |
PD | 21 (8) |
Primary controlled at OMD diagnosis | |
Yes | 195 (80) |
No | 50 (20) |
No. of treated lesion(s) with LAT | |
1 | 187 (77) |
2 | 48 (19) |
3 | 9 (3.5) |
4 | 1 (0.5) |
No. of treated organ(s) with LAT at OMD diagnosis | |
1 | 243 (99) |
2 | 2 (1) |
Cranial vs. Extracranial metastatic disease | |
Cranial | 128 (53) |
Extracranial | 117 (47) |
Systemic treatment for metachronous OMD/OPD | |
Yes | 18 (7) |
No | 227 (93) |
Additional non stereotactic local therapies | |
Surgery | 10 (4) |
RFA | 2 (1) |
None | 233 (95) |
Adjuvant SRS/SABR | |
Yes | 8 (3) |
No | 237 (97) |
Variable | Progression-Free Survival | Overall Survival | ||||||
---|---|---|---|---|---|---|---|---|
Univariate | Multivariate | Univariate | Multivariate | |||||
HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | |
Age | 0.98 (0.96–0.99) | 0.009 | NS | - | NS | - | NS | - |
Stage IV at diagnosis | 2.03 (1.47–2.81) | <0.001 | NS | - | 1.62 (1.14–2.30) | 0.007 | NS | - |
Nodal involvement at baseline (N+) | 1.70 (1.24–2.33) | 0.001 | NS | - | 1.71 (1.20–2.45) | 0.003 | 1.6 (1.1–2.4) | 0.049 |
No response after primary treatment | 2.04 (1.25–3.34) | 0.005 | NS | - | NS | - | NS | - |
ECOG PS = 1 | 1.75 (1.27–2.41) | 0.001 | 1.9 (1.3–2.6) | <0.001 | 2.06 (1.46–2.92) | <0.001 | 1.7 (1.1–2.6) | 0.011 |
Type of oligometastatic disease | 1.21 (1.07–1.37) | 0.002 | NS | - | NS | - | NS | - |
No. of lesions at OMD diagnosis | 1.27 (1.09–1.48) | 0.003 | NS | - | 1.29 (1.07–1.55) | 0.007 | NS | - |
Primary tumor uncontrolled | 1.78 (1.24–2.55) | 0.002 | NS | - | 1.65 (1.11–2.44) | 0.013 | NS | - |
Intracranial metastatic disease | 2.78 (2.00–3.83) | <0.001 | 2.4 (1.7–3.4) | <0.001 | 2.79 (1.90–4.10) | <0.001 | 2.3 (1.4–3.9) | 0.001 |
CMT for OMD | 2.5 (1.7–3.5) | <0.001 | 1.9 (1.3–2.6) | 0.002 | 1.77 (1.21–2.57) | 0.003 | 1.7 (1.1–2.6) | 0.020 |
No response after LAT | 4.36 (2.27–8.38) | <0.001 | 4.4 (2.2–8.5) | <0.001 | NS | - | NS | - |
New local treatment for PD | NS | - | NS | - | 2.01 (1.35–3.00) | 0.001 | NS | - |
No local treatment for PD vs. Intracranial vs. Extracranial new site of local treatment | NA | - | NA | - | 1.85 (1.41–2.43) | <0.001 | 2.2 (1.6–3.1) | <0.001 |
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Badellino, S.; Levis, M.; Cuffini, E.M.; Cerrato, M.; Orlandi, E.; Chiovatero, I.; Aprile, A.; Gastino, A.; Cavallin, C.; Iorio, G.C.; et al. Role of Radiosurgery and Stereotactic Ablative Radiotherapy for Oligometastatic Non-Oncogene Addicted NSCLC. Cancers 2022, 14, 1465. https://doi.org/10.3390/cancers14061465
Badellino S, Levis M, Cuffini EM, Cerrato M, Orlandi E, Chiovatero I, Aprile A, Gastino A, Cavallin C, Iorio GC, et al. Role of Radiosurgery and Stereotactic Ablative Radiotherapy for Oligometastatic Non-Oncogene Addicted NSCLC. Cancers. 2022; 14(6):1465. https://doi.org/10.3390/cancers14061465
Chicago/Turabian StyleBadellino, Serena, Mario Levis, Erica Maria Cuffini, Marzia Cerrato, Erika Orlandi, Ilaria Chiovatero, Arianna Aprile, Alessio Gastino, Chiara Cavallin, Giuseppe Carlo Iorio, and et al. 2022. "Role of Radiosurgery and Stereotactic Ablative Radiotherapy for Oligometastatic Non-Oncogene Addicted NSCLC" Cancers 14, no. 6: 1465. https://doi.org/10.3390/cancers14061465