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Lim AR, Rim CH. Oligometastasis: Expansion of Curative Treatments in the Field of Oncology. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1934. [PMID: 38003982 PMCID: PMC10672750 DOI: 10.3390/medicina59111934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023]
Abstract
Oligometastasis is defined as the presence of several limited metastatic lesions and is generally limited to three or fewer than five metastatic lesions. Previously, the treatment of metastatic cancer aimed to alleviate symptoms rather than cure them; however, the use of immunotherapy or targeted therapy has greatly improved patient life expectancy. Additionally, the effectiveness and safety of local treatment have recently been proven for oligometastatic cancers and have significantly improved patient survival and decreased recurrence rates. A few metastatic studies on lung cancer have demonstrated the usefulness of combining radiation therapy and immunotherapy. Recently, local and targeted therapy combinations have shown promising results in treating non-small cell lung cancer, predominantly caused by the epidermal growth factor receptor and anaplastic lymphoma kinase gene mutations, suggesting the potential of these new treatment strategies. It is well known that oligometastasis has better clinical results than polymetastasis; however, research on the biological profile of oligometastasis is still lacking. Studies using circulating tumor DNA and circulating tumor cells are at the initial stages of providing a better understanding of oligometastatic cancers, and the biological characteristics of these cancers may be revealed based on more diverse studies. With the development of these treatments, the prognosis for patients with oligometastatic cancers is steadily improving, and if the biological profile is revealed, customized treatment may be provided.
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Affiliation(s)
- Ah Reum Lim
- Department of Internal Medicine, Division of Oncology, Korea University Ansan Hospital, Korea University, Ansan-si 15355, Republic of Korea;
| | - Chai Hong Rim
- Department of Radiation Oncology, Korea University Ansan Hospital, Korea University, Ansan-si 15355, Republic of Korea
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Pacifico P, Colciago RR, De Felice F, Boldrini L, Salvestrini V, Nardone V, Desideri I, Greco C, Arcangeli S. A critical review on oligometastatic disease: a radiation oncologist's perspective. Med Oncol 2022; 39:181. [PMID: 36071292 PMCID: PMC9452425 DOI: 10.1007/s12032-022-01788-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/30/2022] [Indexed: 11/24/2022]
Abstract
Since the first definition by Hellman and Weichselbaum in 1995, the concept of OligoMetastatic Disease (OMD) is a growing oncology field. It was hypothesized that OMD is a clinical temporal window between localized primary tumor and widespread metastases deserving of potentially curative treatment. In real-world clinical practice, OMD is a “spectrum of disease” that includes a highly heterogeneous population of patients with different prognosis. Metastasis directed therapy with local ablative treatment have proved to be a valid alternative to surgical approach. Stereotactic body radiation therapy demonstrated high local control rate and increased survival outcomes in this setting with a low rate of toxicity. However, there is a lack of consensus regarding many clinical, therapeutic, and prognostic aspects of this disease entity. In this review, we try to summarize the major critical features that could drive radiation oncologists toward a better selection of patients, treatments, and study endpoints. With the help of a set of practical questions, we aim to integrate the literature discussion.
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Affiliation(s)
- Pietro Pacifico
- School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy. .,Department of Radiation Oncology, Ospedale S. Gerardo, Via G. B. Pergolesi, 20900, Monza, MB, Italy.
| | - Riccardo Ray Colciago
- School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy.,Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Luca Boldrini
- Radiology, Radiation Oncology and Hematology Department, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy
| | | | - Valerio Nardone
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Isacco Desideri
- Department of Radiation Oncology, General Regional Hospital F. Miulli, Acquaviva delle Fonti, Bari, Italy
| | - Carlo Greco
- Department of Radiation Oncology, Campus Bio-Medico University of Rome, Rome, Italy
| | - Stefano Arcangeli
- School of Medicine and Surgery, University of Milan Bicocca, Milan, Italy.,Department of Radiation Oncology, Ospedale S. Gerardo, Via G. B. Pergolesi, 20900, Monza, MB, Italy
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