背景:立体定向放疗(SBRT)用于寡转移癌患者的最佳剂量和分割仍未知。在这份对OligoCare的中期分析中,我们分析了与SBRT剂量和分级相关的因素.
方法:分析基于前1,099名注册患者。SBRT剂量转换为生物有效剂量(BED),使用10Gy的α/β对所有原发,和10Gy的癌症特异性α/β用于非小细胞肺癌和结直肠癌(NSCLC,CRC),2.5Gy用于乳腺癌(BC),或1.5Gy前列腺癌(PC)。
结果:在1,099名患者的中期分析人群中,999(99.5%)符合纳入标准,接受转移导向SBRT治疗非小细胞肺癌(n=195;19.5%),BC(n=163;16.3%),CRC(n=184;18.4%),或PC(n=457;47.5%)。三分之二的患者接受单一转移治疗。分数的中位数为5(IQR,3-5),每个分数的中位剂量为9.7(IQR,7.7-12.4)Gy。最常治疗的部位是非椎骨(22.8%),肺(21.0%),远处淋巴结转移(19.0%)。在多变量分析中,原发性癌症类型的剂量差异显著(BC:237.3GyBED,PC300.6Gy床,和CRC84.3GyBED),和转移部位,肺部和肝脏病变的剂量更高。
结论:这个现实世界的分析表明,SBRT的剂量被调整到原发性癌症和寡转移的位置。未来的分析将讨论这种适应位点和疾病的SBRT分级方法的安全性和有效性(NCT03818503)。
BACKGROUND: Optimal dose and fractionation in stereotactic body radiotherapy (SBRT) for oligometastatic cancer patients remain unknown. In this interim analysis of OligoCare, we analyzed factors associated with SBRT dose and fractionation.
METHODS: Analysis was based on the first 1,099 registered patients. SBRT doses were converted to biological effective doses (BED) using α/β of 10 Gy for all primaries, and cancer-specific α/β of 10 Gy for non-small cell lung and colorectal cancer (NSCLC, CRC), 2.5 Gy for breast cancer (BC), or 1.5 Gy for prostate cancer (PC).
RESULTS: Of the interim analysis population of 1,099 patients, 999 (99.5 %) fulfilled inclusion criteria and received metastasis-directed SBRT for NSCLC (n = 195; 19.5 %), BC (n = 163; 16.3 %), CRC (n = 184; 18.4 %), or PC (n = 457; 47.5 %). Two thirds of patients were treated for single metastasis. Median number of fractions was 5 (IQR, 3-5) and median dose per fraction was 9.7 (IQR, 7.7-12.4) Gy. The most frequently treated sites were non-vertebral bone (22.8 %), lung (21.0 %), and distant lymph node metastases (19.0 %). On multivariate analysis, the dose varied significantly for primary cancer type (BC: 237.3 Gy BED, PC 300.6 Gy BED, and CRC 84.3 Gy BED), and metastatic sites, with higher doses for lung and liver lesions.
CONCLUSIONS: This real-world analysis suggests that SBRT doses are adjusted to the primary cancers and oligometastasis location. Future analysis will address safety and efficacy of this site- and disease-adapted SBRT fractionation approach (NCT03818503).