TY - JOUR
T1 - Definitive dose thoracic radiation therapy in oligometastatic non-small cell lung cancer
T2 - A hypothesis-generating study
AU - Xanthopoulos, Eric P.
AU - Handorf, Elizabeth
AU - Simone, Charles B.
AU - Grover, Surbhi
AU - Fernandes, Annemarie T.
AU - Sharma, Sonam
AU - Corradetti, Michael N.
AU - Evans, Tracey L.
AU - Langer, Corey J.
AU - Mitra, Nandita
AU - Shah, Anand
AU - Apisarnthanarax, Smith
AU - Lin, Lilie L.
AU - Rengan, Ramesh
N1 - Publisher Copyright:
© 2015 American Society for Radiation Oncology.
PY - 2015
Y1 - 2015
N2 - Purpose: A subset of patients with minimal extrathoracic disease may benefit from aggressive primary tumor treatment. We report comparative outcomes in oligometastatic non-small cell lung cancer (NSCLC) treated with and without definitive, conventionally fractionated thoracic radiation therapy. Methods and materials: We identified consecutive patients with stage IV NSCLC who had an Eastern Cooperative Oncology Group performance status ≤. 2 and ≤. 4 total sites of metastatic disease and who had been prescribed ≥. 50 Gy of thoracic radiation. Results: Twenty-nine patients with oligometastatic NSCLC were identified between January 2004 and August 2010. Median survival was 22 months from diagnosis. Four patients (14%) experienced pneumonitis greater than or equal to grade 3; 6 (21%) had esophagitis greater than or equal to grade 3. Local control was associated with improved survival (P =02). In matched subset analysis, median survival was 9 months (P <.01) in patients who received chemotherapy alone. Median time to local failure was 18 versus 6 months (P =01). On multivariable analysis, radiation (P <.01; odds ratio [OR], 0.33), fewer metastases (P <.01; OR, 2.14), and female sex (P <.01; OR, 0.41) were associated with improved survival. Conclusions: Definitive dose radiation therapy may improve survival in a select subset of patients with minimal extrathoracic disease in whom local progression is of primary concern. Prospective trials are needed to further evaluate the role of local control in oligometastatic NSCLC.
AB - Purpose: A subset of patients with minimal extrathoracic disease may benefit from aggressive primary tumor treatment. We report comparative outcomes in oligometastatic non-small cell lung cancer (NSCLC) treated with and without definitive, conventionally fractionated thoracic radiation therapy. Methods and materials: We identified consecutive patients with stage IV NSCLC who had an Eastern Cooperative Oncology Group performance status ≤. 2 and ≤. 4 total sites of metastatic disease and who had been prescribed ≥. 50 Gy of thoracic radiation. Results: Twenty-nine patients with oligometastatic NSCLC were identified between January 2004 and August 2010. Median survival was 22 months from diagnosis. Four patients (14%) experienced pneumonitis greater than or equal to grade 3; 6 (21%) had esophagitis greater than or equal to grade 3. Local control was associated with improved survival (P =02). In matched subset analysis, median survival was 9 months (P <.01) in patients who received chemotherapy alone. Median time to local failure was 18 versus 6 months (P =01). On multivariable analysis, radiation (P <.01; odds ratio [OR], 0.33), fewer metastases (P <.01; OR, 2.14), and female sex (P <.01; OR, 0.41) were associated with improved survival. Conclusions: Definitive dose radiation therapy may improve survival in a select subset of patients with minimal extrathoracic disease in whom local progression is of primary concern. Prospective trials are needed to further evaluate the role of local control in oligometastatic NSCLC.
UR - https://www.scopus.com/pages/publications/84937162986
U2 - 10.1016/j.prro.2014.11.006
DO - 10.1016/j.prro.2014.11.006
M3 - Article
C2 - 25649540
AN - SCOPUS:84937162986
SN - 1879-8500
VL - 5
SP - e355-e363
JO - Practical Radiation Oncology
JF - Practical Radiation Oncology
IS - 4
ER -