Study
Year
Number of patients
Primary site
Treated site
Dose
Local control
Overall survival
Toxicity
Casamassima
2012
48
Multiple
Adrenal
Most common 36 Gy/3 fractions
90 % (2 years)
40 % (1 year); 15 % (2 years)
No gr3
Scorsetti
2012
34
Multiple (most NSCLC)
Adrenal
Median 40 Gy/5 fractions
32 % (2 years)
MS 22 months
No gr3
Oshiro
2011
19
NSCLC
Adrenal
Median 45 Gy/10 fractions
68 % response rate
33 % (2 years)
No gr3
Holy
2011
18
NSCLC
Adrenal
20–40 Gy/5 fractions
77 % (2 years)
MS 23 months
No gr3
Torok
2011
7
Multiple (most lung)
Adrenal
16 Gy/1 fraction or 27 Gy/3 fractions
63 % (1 year)
MS 8 months
NR
Chawla
2009
14
Multiple (most lung)
Adrenal
16 Gy/4 fractions to 50 Gy/10 fractions
55 % (1 year); 27 % (2 years)
44 % (1 year); 25 % (2 years)
No gr3
Jereczek-Fossa
2014
69
Multiple
Lymph Node (Single)
Median 24 Gy/3 fractions
81 % (1 year); 64 % (3 years)
50 % (3 years)
3 % acute gr3; 1 % late gr4
Choi
2009
30
Uterus
Lymph Node (single)
33–45 Gy/3fx
67 % (4 years)
50 % (4 years)
3 % late gr 3–4
Kim
2009
7
Gastric
Lymph Node
Median 48 Gy/3 fractions
29 % (3 years PFS)
43 % (3 years)
No gr3
Table 12.2
Summary of experience with SBRT for treatment of oligometastatic disease to lung or liver
Study | Year | Number of patients | Primary site | Treated site | Dose | Local control | Overall survival | Toxicity |
|---|---|---|---|---|---|---|---|---|
Navarria | 2014 | 76 | Multiple | Lung | 48 Gy/4 fractions (peripheral); 60 Gy/8 fractions (central); 60 Gy/3 fractions (peripheral <2 cm) | 89 % (2 years and 3 years) | 73 % (2 years); 73 % (3 years) | No gr3 |
Ricardi | 2012 | 61 | Multiple | Lung | 26 Gy/1 fraction; 45 Gy/3 fractions; or 36 Gy/4 fractions | 89 % (2 years); 83 % (3 years) | 66 % (2 years); 52 % (3 years) | 2 % gr3 pneumonitis |
McCammon | 2009 | 141 | Multiple | Lung | Most 60 Gy/3 fractions | 100 % (1 year); 89 % (3 years) if ≥60 Gy | NR | 5 % gr3; 1 % gr4 |
Rusthoven | 2009(a) | 38 | Multiple | Lung | 48–60 Gy/3fx | 100 % (1 year); 96 % (2 years) | 39 % (2 years) | 8 % gr3 |
Norihisa | 2008 | 34 | Multiple | Lung | 48 Gy/4 fractions or 60 Gy/5 fractions | 84 % (2 years) | 90 % (2 years) | 3 % gr3 |
Okunieff | 2006 | 50 | Multiple | Lung | 50 Gy/10 fractions | 85 % (3 years) | 71 % (1 year); 255 (3 years) | 2 % gr3 |
Chang | 2011 | 65 | Colorectal | Liver | Median 41.7 Gy/6 fractions | 67 % (1 year), 55 % 92 years) | 72 % (1 year), 38 % (2 years) | 3 % acute gr3; 6 % late gr3 |
Rule | 2011 | 27 | Multiple | Liver | 30 Gy/3 fractions; 50 Gy/5 fractions; or 60 Gy/5 fractions | 100 % (3 years, 60 Gy) | 50 %/67 %/56 % (2 years for 30 Gy/50 Gy/60 Gy) | 4 % gr3 |
van der Pool | 2010 | 20 | Colorectal | Liver | 37.5 Gy/3 fractions | 74 % (2 years) | 83 % (2 years) | 10 % gr3 |
Goodman | 2010 | 26 | Multiple | Liver | 18, 22, 26, or 30 Gy/1 fraction | 77 % (1 year) | 50 % (2 years) | No gr3 |
Rusthoven | 2009 | 47 | Multiple | Liver | Most 60 Gy/3 fractions | 95 % 91 years), 92 % (2 years) | 30 % (2 years) | 2 % gr3 |
Lee | 2009 | 68 | Multiple | Liver | 24 Gy/6 fractions | 71 % (1 year) | 47 % (18 months) | 9 % acute gr3, 1 % acute gr4; 1 death from bowel obstruction |
Katz | 2007 | 60 | Multiple | Liver | 50 Gy/5 fractions | 76 % (10 months), 57 % (20 months) | MS 14.5 months | No gr3 |
Kavanagh | 2006 | 36 | Multiple | Liver | 60 Gy/3 fractions | 93 % (18 months) | NR | 6 % gr3 |
Mendez Romero | 2006 | 17 | Multiple (most colorectal) | Liver | 37.5 Gy/3 fractions | 100 % (1 year), 86 % (2 years) | 85 % (1 year), 62 % (2 years) | 12 % gr3 acute, 4 % gr3 late |
The majority of local recurrences occur within the first 2 years.
Although the majority of patients will have disease progression after ablation of oligometastatic disease, SBRT can serve to delay progression and postpone the need for additional systemic therapy (Table 12.3).
Table 12.3
Summary of experience with SBRT to mixed oligometastatic sites
Study | Year | Number of patients | Primary site | Treated site | Dose | Local control | Overall survival | Toxicity |
|---|---|---|---|---|---|---|---|---|
Comito | 2014 | 82 | Colorectal | Multiple | 48–75 Gy/3–4 fractions | 80 % (2 years); 75 % (3 years) | 65 % (2 years); 43 % (3 years) | No gr3 |
Jereczek-Fossa | 2013 | 95 | Multiple | Multiple | Median 24 Gy/3fx | 67 % (3 years) | 31 % (3 years) | |
Sole | 2013 | 42 | Multiple | Multiple | Median 39 Gy/3fx | 92 % (1 year), 86 % (2 years) | 84 % 91 years), 63 % (2 years) | 14 % gr2 or higher |
Bae | 2012 | 41 | Colorectal | Multiple | Median 48 Gy/3 fractions | 64 % (3 years); 57 % (5 years) | 60 % (3 years); 38 % (5 years) | No acute gr3; 7 % late gr3 |
Salama | 2012 | 61 | Multiple | Multiple | Increasing 24–48 Gy/3 fractions | 67 % (2 years), 88 % if dose ≥30 Gy | 81 % (1 year), 57 % (2 years) | 3 % acute gr3, 10 % late gr3 |
Milano | 2012 | 121 | Multiple | Multiple | Median 50 Gy/10 fractions | 74 %/87 % (2 years non-breast/ breast); 65 %/87 % (6 years non-breast/breast) | 39 %/74 % (2 years non-breast/ breast); 9 %/47 % (6 years non-breast/breast) | 1 % gr3 |
Greco | 2011 | 103 | Multiple | Multiple | 18–24 Gy/1 fraction | 64 % (18 months); 82 % (18 months, dose 24 Gy) | NR | 1 % acute gr3, 3 % late gr3 |
Kang | 2011 | 59 | Colorectal | Multiple | 36–51 Gy/3 fractions | 19 % (5 years) | 29 % (5 years) | 3 % gr4 |
Inoue | 2010 | 44
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