Second chance for cure: Stereotactic ablative radiotherapy in oligometastatic disease.

Authors

Nidal Salim

Nidal Salim

European Medical Center, Moscow, Russian Federation

Nidal Salim , Kristina Tumanova , Alexey Popodko , Eugene Libson

Organizations

European Medical Center, Moscow, Russian Federation, Moscow, Schepkina 35, Moscow, Russian Federation, Hadassah Medical Center, Jerusalem, Israel

Research Funding

No funding received
None.

Background: Local ablative therapy, such as radiation therapy or surgery plays a key role in treatment of patients with oligometastatic disease. Stereotactic ablative radiotherapy (SABR) comes to the fore as a safe and effective treatment option for patients with a limited number of metastases, even those located in hard-to-reach body sites. Many researchers have suggested that metastatic direct therapy (MDT) could improve long-term progression-free and overall survival (PFS and OS) in patients with 1-5 metastatic lesions. Methods: This was a retrospective, single-arm, observational, evaluation study between July 2015 to February 2022. In our institute 60 patients with controlled primary tumors and 1-5 metastases were treated with SABR.We did not exclude patients who subsequently had intracranial metastases from the analysis (n 3). Prescribed radiation doses ranged from 24 to 60 Gy administered in one to seven fractions. Primary endpoint was PFS and the secondary endpoints were OS and toxicity. Results: The most common primary malignancy types were prostate cancer (n 14), colon (n 10), lung (n 7), breast (n 6), melanoma (n 6) and gynecology malignancies (n 6). Median follow-up was 30 months, ranging from 9 to 79. The 1, 3 and 5-year OS rate was 98,3%, 84,4% and 73,8% respectively, the median time to first progression was 15 (range 2 - 32) months. 36 (60%) patients have no recurrence. Two of three patients with intracranial metastases were alive at the end of the study. There were no grade 3-5 adverse events related to specific treatment of SABR. In our analysis, neither the number of metastases nor the primary site were independent prognostic factors. Conclusions: In our retrospective analysis, SABR was associated with high levels of PFS and OS in patients with oligometastatic disease. The limitations of our study were lacking high-level evidence, randomized studies to compare SABR and palliative standard-of-care are mandatory.

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Abstract Details

Meeting

2023 ASCO Breakthrough

Session Type

Poster Session

Session Title

Poster Session A

Track

Breast Cancer,Central Nervous System Tumors,Developmental Therapeutics,Genitourinary Cancer,Hematologic Malignancies,Thoracic Cancers,Other Malignancies or Topics

Sub Track

Advanced Disease

Citation

JCO Global Oncology 9, 2023 (suppl 1; abstr 154)

DOI

10.1200/GO.2023.9.Supplement_1.154

Abstract #

154

Poster Bd #

F8

Abstract Disclosures

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