Clinical outcomes of stereotactic brain and/or body radiotherapy for patients with oligometastatic lesions.

摘要

OBJECTIVE: Several recent studies have shown that oligometastatic disease has curative potential, although it was previously considered to signal a patient's last stage of life. Stereotactic body radiotherapy has been available for extra-cranial metastases in addition to stereotactic cranial radiotherapy for brain metastases. The aim of the present study was to retrospectively evaluate the clinical outcomes of stereotactic radiotherapy for patients with oligometastatic lesions. METHODS: Between 1999 and 2008, 41 patients with five or fewer detectable metastases were treated with stereotactic radiotherapy at our institution. The treated oligometastatic lesions were in the brain, lung and adrenal glands. RESULTS: With a median follow-up period of 20 months, the 3-year overall survival, progression-free survival, local control and distant control rates were 39%, 20%, 80% and 35%, respectively, and the respective 5-year rates were 28%, 20%, 80% and 35%. The median survival time was 24 months. According to interval to recurrence, the 3- and 5-year overall survival rates were 19% and 10%, respectively, for patients with <12 months (n = 18), compared with 53% and 40% for those with > or =12 months (n = 23) (P = 0.006). CONCLUSIONS: Precise stereotactic radiotherapy was effective in controlling oligometastatic lesions for patients with a median survival time of 24 months. Interval to recurrence may impact the overall survival rate and should be included in the stratification criteria in a prospective randomized trial to investigate the benefits of stereotactic radiotherapy for patients with oligometastases.