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Published in: Journal of Cancer Research and Clinical Oncology 7/2017

01-07-2017 | Original Article – Clinical Oncology

Role of stereotactic body radiation therapy for lung metastases from radio-resistant primary tumours

Authors: Davide Franceschini, Luca Cozzi, Fiorenza De Rose, Piera Navarria, Ciro Franzese, Tiziana Comito, Cristina Iftode, Angelo Tozzi, Lucia Di Brina, Anna Maria Ascolese, Elena Clerici, Giuseppe D’Agostino, Antonella Fogliata, Marta Scorsetti

Published in: Journal of Cancer Research and Clinical Oncology | Issue 7/2017

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Abstract

Objectives

A retrospective analysis was performed on patients treated for lung oligo-metastatic disease from radio-resistant histology groups.

Methods

The primary end point was local control (LC), secondary end points were overall survival (OS) and progression free survival (PFS). Toxicity was scored according to CTCAE 4.03.

Results

200 patients were analyzed: 49.5% of the cases derived from colorectal primary tumors, 20.5% from sarcomas, 12.0% from renal cell carcinoma and the rest from other mixed origin. The mean follow-up was 24.2 months. LC at 1 and 2 years was 91, 84.9%. Primary histology and the presence of extra-pulmonary disease had a significant impact on LC. OS at 1 and 2 years was 88.7, 65.4%. Primary histology, disease free interval, presence of extra-pulmonary disease, number of irradiated lung lesions and age showed a correlation with prognosis at univariate analysis. PFS at 1 and 2 years was 84, 57.7%. The presence of extra-pulmonary disease and the number of irradiated lung lesions correlated with prognosis. Treatment was well tolerated with no G3–4 acute or late toxicity recorded.

Conclusion

Colorectal metastases showed a higher rate of local relapse. However, the factors mostly influencing prognosis were the presence of extra-pulmonary disease and the number of lung lesions.
Literature
go back to reference Ahmed KA, Fulp WJ, Berglund AE, Hoffe SE, Dilling TJ, Eschrich SA, Shridhar R, Torres-Roca JF (2015) Differences between colon cancer primaries and metastases using a molecular assay for tumor radiation sensitivity suggest implications for potential oligometastatic SBRT patient selection. Int J Radiat Oncol Biol Phys 92(4):837–842CrossRefPubMedPubMedCentral Ahmed KA, Fulp WJ, Berglund AE, Hoffe SE, Dilling TJ, Eschrich SA, Shridhar R, Torres-Roca JF (2015) Differences between colon cancer primaries and metastases using a molecular assay for tumor radiation sensitivity suggest implications for potential oligometastatic SBRT patient selection. Int J Radiat Oncol Biol Phys 92(4):837–842CrossRefPubMedPubMedCentral
go back to reference Ahmed KA, Caudell JJ, El-Haddad G, Berglund AE, Welsh EA, Yue B, Hoffe SE, Naghavi AO, Abuodeh YA, Frakes JM, Eschrich SA, Torres-Roca JF (2016) Radiosensitivity differences between liver metastases based on primary histology suggest implications for clinical outcomes after stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 95(5):1399–1404CrossRefPubMed Ahmed KA, Caudell JJ, El-Haddad G, Berglund AE, Welsh EA, Yue B, Hoffe SE, Naghavi AO, Abuodeh YA, Frakes JM, Eschrich SA, Torres-Roca JF (2016) Radiosensitivity differences between liver metastases based on primary histology suggest implications for clinical outcomes after stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 95(5):1399–1404CrossRefPubMed
go back to reference Aloia TA, Vauthey JN, Loyer EM et al (2006) Solitary colorectal liver metastasis: resection determines outcome. Arch Surg 141:460–466 (discussion: 466–467) CrossRefPubMed Aloia TA, Vauthey JN, Loyer EM et al (2006) Solitary colorectal liver metastasis: resection determines outcome. Arch Surg 141:460–466 (discussion: 466–467) CrossRefPubMed
go back to reference Binkley MS, Trakul N, Jacobs LR, von Eyben R, Le QT, Maxim PG, Loo BW Jr, Shultz DB, Diehn M (2015 ) Colorectal histology is associated with an increased risk of local failure in lung metastases treated with stereotactic ablative radiation therapy. Int J Radiat Oncol Biol Phys 92(5):1044–1052CrossRefPubMed Binkley MS, Trakul N, Jacobs LR, von Eyben R, Le QT, Maxim PG, Loo BW Jr, Shultz DB, Diehn M (2015 ) Colorectal histology is associated with an increased risk of local failure in lung metastases treated with stereotactic ablative radiation therapy. Int J Radiat Oncol Biol Phys 92(5):1044–1052CrossRefPubMed
go back to reference Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG (2009) Neuro-cognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole brain irradiation: a randomized controlled trial. Lancet Oncol 10:1037–1044CrossRefPubMed Chang EL, Wefel JS, Hess KR, Allen PK, Lang FF, Kornguth DG (2009) Neuro-cognition in patients with brain metastases treated with radiosurgery or radiosurgery plus whole brain irradiation: a randomized controlled trial. Lancet Oncol 10:1037–1044CrossRefPubMed
go back to reference Clarke JW, Register S, McGregor JM, Grecula JC, Mayr NA, Wang JZ et al (2010) Stereotactic radiosurgery with or without whole brain radiotherapy for patients with a single radioresistant brain metastasis. Am J Clin Oncol 33:70–74CrossRefPubMed Clarke JW, Register S, McGregor JM, Grecula JC, Mayr NA, Wang JZ et al (2010) Stereotactic radiosurgery with or without whole brain radiotherapy for patients with a single radioresistant brain metastasis. Am J Clin Oncol 33:70–74CrossRefPubMed
go back to reference De Giacomo T, Rendina EA, Venuta F, Ciccone AM, Coloni GF (1999) Thoracoscopic resection of solitary lung metastases from colorectal cancer is a viable therapeutic option. Chest 115:1441–1443CrossRefPubMed De Giacomo T, Rendina EA, Venuta F, Ciccone AM, Coloni GF (1999) Thoracoscopic resection of solitary lung metastases from colorectal cancer is a viable therapeutic option. Chest 115:1441–1443CrossRefPubMed
go back to reference Eschrich SA, Pramana J, Zhang H et al (2009) A gene expression model of intrinsic tumor radiosensitivity: prediction of response and prognosis after chemoradiation. Int J Radiat Oncol Biol Phys 75:489–496CrossRefPubMedPubMedCentral Eschrich SA, Pramana J, Zhang H et al (2009) A gene expression model of intrinsic tumor radiosensitivity: prediction of response and prognosis after chemoradiation. Int J Radiat Oncol Biol Phys 75:489–496CrossRefPubMedPubMedCentral
go back to reference Fong Y, Cohen AM, Fortner JG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15:938–946CrossRefPubMed Fong Y, Cohen AM, Fortner JG et al (1997) Liver resection for colorectal metastases. J Clin Oncol 15:938–946CrossRefPubMed
go back to reference Hoyer M, Roed H, Traberg Hansen A et al (2006) Phase II study on stereotactic body radiotherapy of colorectal metastases. Acta Oncol 45:823–830CrossRefPubMed Hoyer M, Roed H, Traberg Hansen A et al (2006) Phase II study on stereotactic body radiotherapy of colorectal metastases. Acta Oncol 45:823–830CrossRefPubMed
go back to reference Hyool K, Tae-Young J, In-Young K, Shin J, Kyung-Sub M, Seung-Jin P (2013) The usefulness of stereotactic radiosurgery for radioresistant brain metastases. J Korean Neurosurg Soc 54:107–111CrossRef Hyool K, Tae-Young J, In-Young K, Shin J, Kyung-Sub M, Seung-Jin P (2013) The usefulness of stereotactic radiosurgery for radioresistant brain metastases. J Korean Neurosurg Soc 54:107–111CrossRef
go back to reference Lee MT, Kim JJ, Dinniwell R et al (2009) Phase I study of individualized stereotactic body radiotherapy of liver metastases. J Clin Oncol 27:1585–1591CrossRefPubMed Lee MT, Kim JJ, Dinniwell R et al (2009) Phase I study of individualized stereotactic body radiotherapy of liver metastases. J Clin Oncol 27:1585–1591CrossRefPubMed
go back to reference Lo SS, Teh BS, Mayr NA et al (2010) Stereotactic body radiation therapy for oligometastases. Discov Med 10:247–254PubMed Lo SS, Teh BS, Mayr NA et al (2010) Stereotactic body radiation therapy for oligometastases. Discov Med 10:247–254PubMed
go back to reference McCammon R, Schefter TE, Gaspar LE et al (2009) Observation of a dose control relationship for lung and liver tumors after stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 73:112–118CrossRefPubMed McCammon R, Schefter TE, Gaspar LE et al (2009) Observation of a dose control relationship for lung and liver tumors after stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 73:112–118CrossRefPubMed
go back to reference Milano MT, Katz AW, Zhang H et al (2012) Oligometastases treated with stereotactic body radiotherapy: long-term follow-up of prospective study. Int J Radiat Oncol Biol Phys 83:878–886CrossRefPubMed Milano MT, Katz AW, Zhang H et al (2012) Oligometastases treated with stereotactic body radiotherapy: long-term follow-up of prospective study. Int J Radiat Oncol Biol Phys 83:878–886CrossRefPubMed
go back to reference Okunieff P, Petersen AL, Philip A et al (2006) Stereotactic body radiation therapy (SBRT) for lung metastases. Acta Oncol 45:808–817CrossRefPubMed Okunieff P, Petersen AL, Philip A et al (2006) Stereotactic body radiation therapy (SBRT) for lung metastases. Acta Oncol 45:808–817CrossRefPubMed
go back to reference Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The international registry of lung metastases. J Thorac Cardiovasc Surg 113:37–49CrossRefPubMed Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The international registry of lung metastases. J Thorac Cardiovasc Surg 113:37–49CrossRefPubMed
go back to reference Powell JW, Chung CT, Hemangini SR, Canute GW, Hodge CJ, Bassano DA (2008) Gamma Knife surgery in the management of radioresistant brain metastases in high-risk patients with melanoma, renal cell carcinoma, and sarcoma. J Neurosurg 109(Suppl):122–128PubMed Powell JW, Chung CT, Hemangini SR, Canute GW, Hodge CJ, Bassano DA (2008) Gamma Knife surgery in the management of radioresistant brain metastases in high-risk patients with melanoma, renal cell carcinoma, and sarcoma. J Neurosurg 109(Suppl):122–128PubMed
go back to reference Salama JK, Chmura SJ, Mehta N et al (2008) An initial report of a radiation dose-escalation trial in patients with one to five sites of metastatic disease. Clin Cancer Res 14:5255–5259CrossRefPubMed Salama JK, Chmura SJ, Mehta N et al (2008) An initial report of a radiation dose-escalation trial in patients with one to five sites of metastatic disease. Clin Cancer Res 14:5255–5259CrossRefPubMed
go back to reference Salama JK, Hasselle MD, Chmura SJ et al (2012) Stereotactic body radiotherapy for multisite extracranial oligometastases: final report of a dose escalation trial in patients with 1 to 5 sites of metastatic disease. Cancer 118:2962–2970CrossRefPubMed Salama JK, Hasselle MD, Chmura SJ et al (2012) Stereotactic body radiotherapy for multisite extracranial oligometastases: final report of a dose escalation trial in patients with 1 to 5 sites of metastatic disease. Cancer 118:2962–2970CrossRefPubMed
go back to reference Shiono S, Ishii G, Nagai K et al (2005) Predictive factors for local recurrence of resected colorectal lung metastases. Ann Thorac Surg 80:1040–1045CrossRefPubMed Shiono S, Ishii G, Nagai K et al (2005) Predictive factors for local recurrence of resected colorectal lung metastases. Ann Thorac Surg 80:1040–1045CrossRefPubMed
go back to reference Shultz DB, Filippi AR, Thariat J et al (2014) Stereotactic ablative radiotherapy for pulmonary oligometastases and oligometastatic lung cancer. J Thorac Oncol 9:1426–1433CrossRefPubMed Shultz DB, Filippi AR, Thariat J et al (2014) Stereotactic ablative radiotherapy for pulmonary oligometastases and oligometastatic lung cancer. J Thorac Oncol 9:1426–1433CrossRefPubMed
go back to reference Sin AH, Cardens RJ, Vannemreddy P, Nanda A (2009) Gamma knife stereotactic radiosurgery for intracranial metastases from conventionally radioresistant primary cancers: outcome analysis of survival and control of brain disease. South Med J 102:41–44CrossRef Sin AH, Cardens RJ, Vannemreddy P, Nanda A (2009) Gamma knife stereotactic radiosurgery for intracranial metastases from conventionally radioresistant primary cancers: outcome analysis of survival and control of brain disease. South Med J 102:41–44CrossRef
go back to reference Takeda A, Kunieda E, Ohashi T et al (2011) Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer. Radiother Oncol 101:255–259CrossRefPubMed Takeda A, Kunieda E, Ohashi T et al (2011) Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer. Radiother Oncol 101:255–259CrossRefPubMed
go back to reference The International Registry of Lung Metastases (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113:37–49CrossRef The International Registry of Lung Metastases (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 113:37–49CrossRef
go back to reference Timmerman RD, Park C, Kavanagh BD (2007) The North American experience with stereotactic body radiation therapy in non-small cell lung cancer. J Thorac Oncol 2:S101–S112CrossRefPubMed Timmerman RD, Park C, Kavanagh BD (2007) The North American experience with stereotactic body radiation therapy in non-small cell lung cancer. J Thorac Oncol 2:S101–S112CrossRefPubMed
go back to reference Timmerman RD, Bizekis CS, Pass HI et al (2009) Local surgical, ablative, and radiation treatment of metastases. CA Cancer J Clin 59:145–170CrossRefPubMed Timmerman RD, Bizekis CS, Pass HI et al (2009) Local surgical, ablative, and radiation treatment of metastases. CA Cancer J Clin 59:145–170CrossRefPubMed
go back to reference van Laarhoven HW, Kaanders JH, Lok J et al (2006) Hypoxia in relation to vasculature and proliferation in liver metastases in patients with colorectal cancer. Int J Radiat Oncol Biol Phys 64:473–482CrossRefPubMed van Laarhoven HW, Kaanders JH, Lok J et al (2006) Hypoxia in relation to vasculature and proliferation in liver metastases in patients with colorectal cancer. Int J Radiat Oncol Biol Phys 64:473–482CrossRefPubMed
go back to reference Welter S, Jacobs J, Krbek T, Krebs B, Stamatis G (2007) Long-term survival after repeated resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg 84:203–210CrossRefPubMed Welter S, Jacobs J, Krbek T, Krebs B, Stamatis G (2007) Long-term survival after repeated resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg 84:203–210CrossRefPubMed
go back to reference Yaeh A, Nanda T, Jani A, Rozenblat T, Qureshi Y, Saad S, Lesser J, Lassman AB, Isaacson SR, Sisti MB, Bruce JN, McKhann GM 2nd, Wang TJ (2015) Control of brain metastases from radioresistant tumors treated by stereotactic radiosurgery. J Neurooncol 124(3):507–514CrossRefPubMed Yaeh A, Nanda T, Jani A, Rozenblat T, Qureshi Y, Saad S, Lesser J, Lassman AB, Isaacson SR, Sisti MB, Bruce JN, McKhann GM 2nd, Wang TJ (2015) Control of brain metastases from radioresistant tumors treated by stereotactic radiosurgery. J Neurooncol 124(3):507–514CrossRefPubMed
Metadata
Title
Role of stereotactic body radiation therapy for lung metastases from radio-resistant primary tumours
Authors
Davide Franceschini
Luca Cozzi
Fiorenza De Rose
Piera Navarria
Ciro Franzese
Tiziana Comito
Cristina Iftode
Angelo Tozzi
Lucia Di Brina
Anna Maria Ascolese
Elena Clerici
Giuseppe D’Agostino
Antonella Fogliata
Marta Scorsetti
Publication date
01-07-2017
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 7/2017
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-017-2373-y

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