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Personalized Diagnosis and Treatment of Oligometastatic Disease
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Personalized Diagnosis and Treatment of Oligometastatic Disease

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: 15 September 2025 | Viewed by 427

Special Issue Editor

Dr. Francesco Cuccia

E-Mail Website
Guest Editor
Radiation Oncology Unit—ARNAS Civico Hospital, 90100 Palermo, Italy
Interests: radiation oncology; radiotherapy physics; stereotactic radiosurgery; intensity-modulated radiotherapy; adaptive radiotherapy; lung cancer; prostate cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, our scientific community has witnessed a revolution in the management of metastatic patients, with increasing availability of novel systemic agents able to prolong the survival with negligible impact on quality of life. The concept of oligometastatic disease is gaining attractiveness as an intermediate state between localized and disseminated disease that is potentially suitable for local treatments with the intent to ablate the metastatic foci. The oligometastatic status was postulated in 1995 by Hellman and Weichselbaum, who identified a metastatic disease burden limited to 3–5 lesions and suitable for local treatments, either via surgery or radiotherapy.

Recently, several prospective and retrospective studies support the role of radiotherapy, particularly stereotactic body radiotherapy (SBRT), as a safe and effective tool for patients with oligometastastic disease, with proven benefits also in terms of survival, as confirmed by the long-term results of the SABR-COMET trial. To date, SBRT is routinely applied in clinical practice alone or in combination with novel systemic agents, with an increased use of this therapeutic option thanks to the availability of refined diagnostic modalities. The combination of technological progress along with the improved knowledge of biomolecular factors as potential candidates for target therapies, have led clinicians to consider SBRT beyond the consolidated numerical limit of 3–5 metastases and explore other parameters such as the total tumor volume. In this sense, the definition of oligometastatic disease has been reconsidered and recategorized.

Moreover, new endpoints such as time to next systemic treatment or systemic treatment-free survival have been reported as a means to quantify the real impact of SBRT in the treatment of oligometastatic disease.

This Special Issue aims to collect the available evidence and new developments in this complex disease scenario, which is constantly changing shape under the wave of technological and biological advances.

Dr. Francesco Cuccia
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • oligometastatic disease
  • oligorecurrence
  • oligoprogression
  • oligoconsolidation
  • metastasectomy
  • stereotactic body radiotherapy (SBRT)
  • novel systemic agents
  • target therapies
  • chemotherapy
  • immunotherapy

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Published Papers (1 paper)

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Research

13 pages, 538 KiB  
Article
Stereotactic Body Radiotherapy for the Treatment of Oligometastases Located in the Peritoneum or in the Abdominal Wall: Preliminary Results from a Mono-Institutional Analysis
by Francesco Cuccia, Salvatore D’Alessandro, Marina Campione, Vanessa Figlia, Gianluca Mortellaro, Antonio Spera, Giulia Musicò, Antonino Abbate, Salvatore Russo, Carlo Messina, Giuseppe Carruba, Livio Blasi and Giuseppe Ferrera
J. Pers. Med. 2025, 15(7), 312; https://doi.org/10.3390/jpm15070312 (registering DOI) - 14 Jul 2025
Abstract
Purpose/Objective(s): Peritoneal carcinosis can occur in several gastrointestinal or gynecological malignancies and its prognosis is usually poor. With the advent of more effective systemic agents, the overall survival of metastatic patients has been revolutionized and isolated peritoneal or abdominal wall metastases might benefit [...] Read more.
Purpose/Objective(s): Peritoneal carcinosis can occur in several gastrointestinal or gynecological malignancies and its prognosis is usually poor. With the advent of more effective systemic agents, the overall survival of metastatic patients has been revolutionized and isolated peritoneal or abdominal wall metastases might benefit from local treatments; Stereotactic Body Radiotherapy (SBRT) might be considered in selected patients with oligometastatic presentation. Materials/Methods: Oligometastases were defined according to recent ESTRO/EORTC consensus. Inclusion criteria were as follows: ECOG PS ≤ 2, written informed consent, up to five lesions to be treated at the same time, patients treated with radiotherapy schedules applying minimum 6 Gy per fraction. The primary endpoint of the study was local control (LC); acute and late toxicity, distant progression-free survival (DPFS), time-to-next systemic treatment (TNST), polymetastatic-free survival (PMFS) and overall survival (OS) were secondary endpoints. Toxicity was assessed according to CTCAE criteria v5.0. Statistical associations between clinical variables and outcomes were assessed using Fisher’s exact test, and Kruskal–Wallis test, as appropriate. Survival outcomes were estimated using the Kaplan–Meier method and compared using the log-rank test. Results: Between April 2020 and September 2024 a total of 26 oligometastatic lesions located in the peritoneum or in the abdominal wall detected in 20 patients received SBRT with Helical Tomotherapy. All cases have been assessed by a multidisciplinary team. Only in three patients out of twenty did more than one lesion receive SBRT: two lesions in two patients, and five lesions in a single case of colorectal cancer with ongoing third-line systemic treatment. Median total dose was 30 Gy (27–35 Gy) in five fractions (3–5). The most frequent primary neoplasm was ovarian cancer in 14/20, endometrial in 2/20, while the remaining were colorectal, vaginal, pancreatic and non-small cell lung cancer. Four lesions were located in the abdominal wall, while the remaining twenty-two were located in the peritoneum. Concurrent systemic therapy was administered in 18/20 patients. With a median follow-up of 15 months (range, 6–59), our 1-year LC was 100%, while 1-year DPFS, PMFS, TNTS and OS rates were 54%, 69%, 61% and 83%, respectively. Abdominal wall location and treatment of a subsequent oligometastatic recurrence with a second course of SBRT were both significantly associated with improved OS (p = 0.03 and p = 0.04, respectively). No G ≥ 3 adverse events occurred. Conclusion: Our preliminary data support the use of SBRT in selected cases of oligometastatic disease located in the peritoneum or in the abdominal wall with excellent results in terms of tolerability and promising clinical outcomes. Full article
(This article belongs to the Special Issue Personalized Diagnosis and Treatment of Oligometastatic Disease)
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