1
|
Scorsetti M, Clerici E, Navarria P, D'Agostino G, Piergallini L, De Rose F, Ascolese A, Tozzi A, Iftode C, Villa E, Comito T, Franzese C, Mancosu P, Tomatis S, Cozzi L. The role of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in the elderly. Br J Radiol 2015; 88:20150111. [PMID: 26183933 DOI: 10.1259/bjr.20150111] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE To report about clinical outcome of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in elderly patients. METHODS Patients with 1-4 inoperable metastases were treated with SBRT. Dose prescription ranged from 40 to 75 Gy in 3-8 fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and disease-specific survival (DSS). RESULTS 82 patients with 111 total metastases were treated. Median age was 79 years. 64 patients (78%) had a single lesion; the remaining patients had 2-4 lesions. 16 (14.4%) lesions were localized in the abdomen, 50 (45.0%) in the liver and 45 (40.5%) in the lungs. Local response was observed for 87 lesions (78.4%) while local progression was observed in 24 lesions (21.6%). Actuarial 1-year LC was 86.8% ± 3.3%. Actuarial 1-year OS was 93.6% ± 2.7%. 2-year findings were 76.3% ± 4.4% and 72.0% ± 5.6%, respectively. Actuarial 1- and 2-year DSS results were 97.5% ± 2.0% and 81.6% ± 4.9%, respectively. Treatment-related Grade 2-3 toxicity was observed in five patients (4.2%); Grade 1 toxicity in seven patients (5.9%) and no toxicity was observed in 85.4% of the cases. CONCLUSION SBRT is a safe and effective therapeutic option for the treatment of oligometastatic disease in the elderly with acceptable rates of LC and low treatment-related toxicity. ADVANCES IN KNOWLEDGE The use of SBRT for oligometastatic disease in the elderly can be considered as a valuable approach, particularly for patients with fragile status or refusing other approaches.
Collapse
Affiliation(s)
- Marta Scorsetti
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Elena Clerici
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Piera Navarria
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Giuseppe D'Agostino
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Lorenzo Piergallini
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Fiorenza De Rose
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Annamaria Ascolese
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Angelo Tozzi
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Cristina Iftode
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Elisa Villa
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Tiziana Comito
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Ciro Franzese
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Pietro Mancosu
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Stefano Tomatis
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Luca Cozzi
- Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| |
Collapse
|