Stereotactic radiation therapy for non-spine bone oligometastases: predictive factors of outcome
PO-1447
Abstract
Stereotactic radiation therapy for non-spine bone oligometastases: predictive factors of outcome
Authors: SIMONA BORGHESI1, Chiara Gasperi2, Francesca Terziani1, Andrea Rampini1, Pernici Paola3, Roberta De Majo1, Silvia Bertocci1, Carmine Iermano4, Pietro Giovanni Gennari1, Pier Luigi Losardo1, Enrico Tucci1
1Azienda USL Toscana Sud Est, San Donato and S. Maria alla Gruccia Hospital, Radiotherapy Department, Arezzo - Valdarno, Italy; 2Azienda USL Toscana Sud Est, San Donato Hospital, Health Department Staff Medical Physics, Arezzo, Italy; 3Azienda USL Toscana Sud Est, San Donato and S. Maria alla Gruccia Hospital, Radiotherapy Department , Arezzo - Valdarno, Italy; 4Azienda USL Toscana Sud Est, San Donato and S. Maria alla Gruccia Hospital , Radiotherapy Department , Arezzo - Valdarno, Italy
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Purpose or Objective
to
examine the toxicity and outcomes of Stereotactic Body Radiation Therapy (SBRT) for non-spine bone metastases.
Material and Methods
Between
2015 and 2018, 40 patients and 46 oligometastatic non-spine bony metastases
were treated with SBRT at the Radiotherapy
Unit of Arezzo-Valdarno, and retrospectively reviewed. CT/PET was fused on simulation CT and used to
outline the target volume in order to reduce inter-observer variation. Local
control (LC), overall survival (OS), and progression-free survival (PFS) were
evaluated and predictive factors for LC were examined. Acute and late toxicity
were reported and graded as per standardized Common Toxicity Criteria for
Adverse Events 4.0 criteria.
Results
The
median age of patients treated was 72 years (range 49-85). The most common
histology was prostate cancer (50%), followed by breast (25%), bladder (10%),
lung (5%), kidney (5%), and rectal cancer (5%). Most of the non-spine bony
metastases laid within the pelvis (80%). Pain was present before SBRT in 50% of
cases and assessed according to the Numerical Rating Scale (NRS). Median SBRT
dose used was 30 Gy (range 25-36) in 3-5 fractions. Early pain relief was
observed in all symptomatic patients. After a median follow up of 27 months
(range 5-60), 1-year LC, OS and PFS rates were 90%, 95% and 72%, respectively.
Local progression occurred in 9 patients with a median time to local failure of
22.5 months. Three patients developed acute toxicity (grade 1 fatigue in 1 case
and grade 1 acute pain flare in 2); no late toxicities were observed.
Predictive factor of better LC was smaller PTV (p = 0.03).
Conclusion
SBRT is a
feasible treatment for non-spine bony metastases and yields high rates of
long-term LC with low acute toxicity and no long term side effects.