目的:寡转移疾病(OMD)局部治疗的疗效尚不清楚。本研究旨在评估OMD分类系统的预后实用性,并探讨哪些群体可能从立体定向放射治疗(SBRT)中受益。
方法:这项单中心回顾性研究纳入了45例(52个部位)实体瘤和1-3例颅外寡转移瘤患者,他们在2018年1月至2021年12月期间在我们机构接受了SBRT治疗。OMD状态是根据欧洲放射治疗和肿瘤学学会(ESTRO)和欧洲癌症研究和治疗组织(EORTC)分类系统进行分类的。本地控制(LC),总生存期(OS),使用Kaplan-Meier方法分析各组的无进展生存期(PFS)。根据不良事件通用术语标准(CTCAE)5.0版评估急性和晚期不良事件(AE)。
结果:中位随访期为14个月(范围:0-48个月)。从头(首次诊断为OMD)的患者人数,重复(OMD的先前历史),和诱导(既往有多转移病史)OMD组分别为15、17和13。整个LC的费率为一年,从头,重复,诱导队列为87.2%,87.5%,90.2%,和83.9%,分别(p=0.80)。各组一年PFS率为35.0%,56.7%,和29.9%,分别(p=0.58)。各组一年OS率为80.0%,86.2%,80.8%,分别(p=0.50)。5例患者发生2级或3级AE(10.4%)。没有观察到4级或5级AE。
结论:SBRT对于局部控制是安全有效的。重复OMD的患者表现出更长的PFS趋势,提示此亚组可能受益于转移部位的局部治疗.
OBJECTIVE: The efficacy of local therapy for oligometastatic disease (OMD) remains unclear. This study aimed to evaluate the prognostic utility of the classification system for OMD and explore which groups may benefit from stereotactic body radiation therapy (SBRT).
METHODS: This single-center retrospective study included 45 patients (52 sites) with solid tumors and 1-3 extracranial
oligometastases who underwent SBRT for all metastases at our institution between January 2018 and December 2021. OMD states were classified based on the European Society for Radiotherapy and Oncology (ESTRO) and the European Organisation for Research and Treatment of Cancer (EORTC) classification system. Local control (LC), overall survival (OS), and progression-free survival (PFS) for each group were analyzed using the Kaplan-Meier method. Acute and late adverse events (AEs) were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
RESULTS: The median follow-up period was 14 months (range: 0-48 months). The numbers of patients in the de novo (first diagnosis of OMD), repeat (previous history of OMD), and induced (previous history of polymetastatic disease) OMD groups were 15, 17, and 13, respectively. The LC rates at one year for the entire, de novo, repeat, and induced cohorts were 87.2%, 87.5%, 90.2%, and 83.9%, respectively (p=0.80). The one-year PFS rates for each group were 35.0%, 56.7%, and 29.9%, respectively (p=0.58). The one-year OS rates for each group were 80.0%, 86.2%, and 80.8%, respectively (p=0.50). Grade 2 or 3 AEs occurred in five patients (10.4%). No grade 4 or 5 AEs were observed.
CONCLUSIONS: SBRT is safe and highly effective for local control. Patients with repeat OMD demonstrated a trend of longer PFS, suggesting that this subgroup may benefit from local therapy at metastatic sites.