Lung metastases from different primary tumors treated with Stereotactic ablative radiotherapy
Jady Vivian Rojas Cordero,
Spain
PO-1253
Abstract
Lung metastases from different primary tumors treated with Stereotactic ablative radiotherapy
Authors: Jady Vivian Rojas Cordero1, Gemma Sancho Pardo2, Katarina Majercakova2, Pedro Gallego Franco3, Pablo Carrasco de Fez3, Ana María Soto Cambres4, Josep Balart Serra2, Núria Farré Bernadó2
1Hospital Santa Creu i Sant Pau, Radiation Oncology, Barcelona, Spain; 2Hospital de la Santa Creu i Sant Pau, Radiation Oncology, Barcelona, Spain; 3Hospital de la Santa Creu i Sant Pau, Radiophysics, Barcelona, Spain; 4Hospital de la Santa Creu i Sant pau, Radiation Oncology, Barcelona, Spain
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Purpose or Objective
To evaluate
the clinical efficacy of stereotactic ablative radiotherapy for all lung
metastases from different primary tumors.
Material and Methods
This is a restrospective
study of patients with lung metastases from different primary tumor histologies
treated with SABR between January 2013 and September 2020.
Inclusion study criteria was:
oligometastases, oligoprogression, oligopersistance, not suitable for surgery, maximum
tumor diameter ≤ 50 mm and a maximum of 4 lung metastases. Pretreatment
evaluation was performed with 18-F-FDG PET/CT scan. Histological confirmation was performed
when feasible. Risk-adapted fractionation was used (5x11Gy,5x10
Gy,8x7.5Gy). Local control (LC),
cancer specific survival (CSS) and overall survival (OS) were retrospectively evaluated using
Kaplan-Meier method. A Multivariate analysis of variance was performed to
assess possible prognostic factors, such as dose, primary
tumor, disease-free interval, SUVmax
post-treatment PET/CT evaluation.
Fig 1. Patient with colorectal cancer with 3 lung nodules treated with SABR.
Results
A total of 110
nodules of 80 patients were irradiated. Median follow-up was 42 months. Median
age was 75 years (range 24-94). Median tumor size was 1.5 cm (range 0.5-4.5
cm). 74.5% were peripherals and 25.5% were central nodules. Pathologically
confirmed metastases were 16. A total of 79 tumors were oligometastases, 10
oligopersistence, and 21 oligoprogressive. According to primary tumor: Lung
cancer 30 patients (37%), Colorectal cancer 29 patients (36.25%), Soft tissue
tumors 7 patients (8.7%), Head & neck cancer 6 patients (7%) and other
histologies 8 patients (8.75%). Median total
dose was 53.9 Gy.
At 3 years
follow-up: in lung cancer LC was 94.4%, OS 69.4% and CSS 77.7%. in colorectal
cancer: LC 63.6%, OS 72%, CSS 75%, soft
tissue tumors LC of 90%, OS and CSS 72% and in Head & neck cancer LC was100%
and CSS 81% (see table 1). There was no significant difference in prognostic
factors in multivariate analysis.
Table 1. Survival data at 1, 2 and 3 years
Conclusion
Our study
showed an excellent LC, CSS and OS for all primary tumors. Comparatively, LC remains lower in colorectal cancer and the
lowest OS at 3 year was observed in lung cancer. Further studies need to be
performed to specify the possible prognostic factors.