Stereotactic radiotherapy for oligometastatic cancer: a prognostic model for survival

• Published in: Annals of oncology Vol. 25; no. 2; pp. 467 - 471
• Main Authors: de Vin, T., Engels, B., Gevaert, T., Storme, G., De Ridder, M.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-02-2014; Oxford University Press
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adenocarcinoma - surgery; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Biological and medical sciences; Brain Neoplasms - mortality; Brain Neoplasms - secondary; Brain Neoplasms - surgery; Disease-Free Survival; Dose Fractionation, Radiation; Female; Humans; Kaplan-Meier Estimate; Lymphatic Metastasis; Male; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Multivariate Analysis; oligometastases; Pharmacology. Drug treatments; Prognosis; prognostic model; Radiosurgery; Retrospective Studies; risk factors; stereotactic body radiotherapy; stereotactic radiosurgery; survival; Tumors; stereotactic body radiotherapy; risk factors; prognostic model; oligometastases; survival; stereotactic radiosurgery; Prognosis; Radiosurgery; Metastasis; Malignant tumor; Radiotherapy; Epidemiology; Survival; Treatment; Risk factor; Models; Cancer
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdt537

Stereotactic radiotherapy (SRT) is a safe and locally effective treatment for patients with inoperable oligometastases. The challenge remains identifying subsets of patients that benefit in terms of overall survival (OS).
Between 2005 and 2011, 309 patients with ≤5 metastases were treated by stereotactic body radiotherapy (n = 209) and/or by intracranial single or fractionated stereotactic radiotherapy (n = 107). We analyzed OS and carried out a risk factor analysis.
The median survival of all patients was 24 months. The 3-, 4- and 5-year OS rates were 32%, 25% and 19%, respectively. The following four risk factors were independently associated with impaired OS: nonadenocarcinoma histology (P < 0.01), intracranial metastases (P < 0.01), synchronous oligometastatic disease (P < 0.01) and male gender (P = 0.02). Patients with 0, 1 and 2 risk factors displayed a median survival (95% CI) of 40 (24–63), 29 (23–35) and 23 (16–29) months, respectively, and are defined as patients with good prognosis. Patients with 3 and 4 risk factors had a median survival of 9 (6–11) and 4 (1–7) months only and are defined as bad prognostic patients.
We identified subsets of oligometastatic cancer patients with good prognosis after SRT. These patients are candidates for inclusion in prospective randomized trials for defining the role of SRT in the management of oligometastases.