Skip to main content
SpringerLink
Log in

Stereotactic ablative radiotherapy delivered by image-guided helical tomotherapy for extracranial oligometastases

  • Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Purpose

To investigate the outcomes and risk factors of patients treated with stereotactic ablative radiotherapy (SABR) delivered by image-guided helical tomotherapy (HT) for extracranial oligometastases.

Methods

From August 2006 through July 2011, 42 consecutive patients (median age 69 years [range 16–87]) with oligometastases (≤3) received HT to all known cancer sites (lung, n = 28; liver, n = 12; adrenal, n = 2). Prognostic factors were assessed by Cox’s proportional hazards regression analysis.

Results

A total of 60 lesions were treated with hypofractionated HT (median dose 39 Gy [range 36–72.5]; median dose per fraction 12 Gy [range 5–20]). Complete or partial response was observed in 40 (54 %) patients. With a median follow-up period of 15 months, 1- and 2-year overall survival (OS) was 84 and 63 %, respectively; and 1- and 2-year local control (LC) was 92 and 86 %, respectively. Four patients had pneumonitis Grade ≥2 and two patients had lower gastrointestinal toxicity Grade ≥2. Only the lack of complete/partial response was associated with higher risk of mortality on univariate (HR = 3.8, P = 0.04) and multivariate (HR = 6.6, P = 0.01) analyses.

Conclusions

SABR delivered by image-guided HT is well tolerated and offers adequate LC with low acute morbidity in patients with extracranial oligometastatic disease. We found that the response to HT was the only predictor for OS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Greene FL, Page DL, Fleming ID et al (2002) Lung. In: AJCC cancer staging manual, 6th edn. Springer, New York

  2. Weichselbaum RR, Hellman S (2011) Oligometastases revisited. Nat Rev Clin Oncol 8:378–382

    PubMed  CAS  Google Scholar 

  3. Lopes JC, Navarro A, Solé JM, Martínez M, Guedea F (2010) Stereotactic body radiation therapy for spinal metastases. Clin Transl Oncol 12:639–642

    Article  PubMed  Google Scholar 

  4. Norihisa Y, Nagata Y, Takayama K et al (2008) Stereotactic body radiotherapy for oligometastatic lung tumors. Int J Radiat Oncol Biol Phys 72:398–403

    Article  PubMed  Google Scholar 

  5. Tomita N, Soga N, Ogura Y et al (2012) Preliminary results of intensity-modulated radiation therapy with helical tomotherapy for prostate cancer. J Cancer Res Clin Oncol. doi:10.1007/s00432-012-1277-0

    PubMed  Google Scholar 

  6. Hoyer M, Swaminath A, Bydder S et al (2012) Radiotherapy for liver metastases: a review of evidence. Int J Radiat Oncol Biol Phys 82:1047–1057

    Article  PubMed  Google Scholar 

  7. Cárdenes HR, Price TR, Perkins SM et al (2010) Phase I feasibility trial of stereotactic body radiation therapy for primary hepatocellular carcinoma. Clin Transl Oncol 12:218–225

    Article  PubMed  Google Scholar 

  8. Oshiro Y, Aruga T, Tsuboi K et al (2010) Stereotactic body radiotherapy for lung tumors at the pulmonary hilum. Strahlenther Onkol 186:274–279

    Article  PubMed  Google Scholar 

  9. Siva S, MacManus M, Ball D (2010) Stereotactic radiotherapy for pulmonary oligometastases: a systematic review. J Thorac Oncol 5:1091–1099

    PubMed  Google Scholar 

  10. Ohtakara K, Hayashi S, Mizuta K et al (2012) Clinical outcomes of single or oligo-fractionated stereotactic radiotherapy for head and neck tumors using micromultileaf collimator-based dynamic conformal arcs. J Cancer Res Clin Oncol 138:1511–1522

    Article  PubMed  Google Scholar 

  11. Lagerwaard FJ, Van Sornsen de Koste JR, Nijssen-Visser MR et al (2001) Multiple “slow” CT scans for incorporating lung tumor mobility in radiotherapy planning. Int J Radiat Oncol Biol Phys 51:932–937

    Article  PubMed  CAS  Google Scholar 

  12. Timmerman R, Galvin J, Michalski J et al (2006) Accreditation and quality assurance for radiation therapy oncology group: multicenter clinical trials using stereotactic body radiation therapy in lung cancer. Acta Oncol 45:779–786

    Article  PubMed  Google Scholar 

  13. Timmerman RD (2008) An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin Radiat Oncol 18:215–222

    Article  PubMed  Google Scholar 

  14. Bentzen SM, Constine LS, Deasy JO et al (2010) Quantitative analyses of normal tissue effects in the clinic (QUANTEC): an introduction to the scientific issues. Int J Radiat Oncol Biol Phys 76:S3–S9

    Article  PubMed  Google Scholar 

  15. Eisenhauer EA, Therasse P, Bogaerts J et al (2009) New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer 45:228–247

    Article  PubMed  CAS  Google Scholar 

  16. Cancer Therapy Evaluation Program (2003) Common terminology criteria for adverse events VB, MD, National Cancer Institute

  17. Feuvret L, Noel G, Mazeron JJ, Bey P (2006) Conformity index: a review. Int J Radiat Oncol Biol Phys 64:333–342

    Article  PubMed  Google Scholar 

  18. Paddick I (2000) A simple scoring ratio to index the conformity of radiosurgical treatment plans. Technical note. J Neurosurg 93:219–222

    PubMed  Google Scholar 

  19. Casamassima F, Livi L, Masciullo S et al (2012) Stereotactic radiotherapy for adrenal gland metastases: university of Florence experience. Int J Radiat Oncol Biol Phys 82:919–923

    Article  PubMed  Google Scholar 

  20. Milano MT, Katz AW, Schell MC et al (2008) Descriptive analysis of oligometastatic lesions treated with curative-intent stereotactic body radiotherapy. Int J Radiat Oncol Biol Phys 72:1516–1522

    Article  PubMed  Google Scholar 

  21. Rusthoven KE, Kavanagh BD, Burri SH et al (2009) Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases. J Clin Oncol 27:1579–1584

    Article  PubMed  Google Scholar 

  22. Chi A, Jang SY, Welsh JS et al (2011) Feasibility of helical tomotherapy in stereotactic body radiation therapy for centrally located early stage nonsmall-cell lung cancer or lung metastases. Int J Radiat Oncol Biol Phys 81:856–862

    Article  PubMed  Google Scholar 

  23. Iwata H, Shibamoto Y, Baba F et al (2011) Correlation between the serum KL-6 level and the grade of radiation pneumonitis after stereotactic body radiotherapy for stage I lung cancer or small lung metastasis. Radiother Oncol 101(267–270):22

    Google Scholar 

  24. Fumagalli I, Bibault JE, Dewas S et al (2012) A single-institution study of stereotactic body radiotherapy for patients with unresectable visceral pulmonary or hepatic oligometastases. Radiat Oncol 7:164

    Article  PubMed  Google Scholar 

  25. Engels B, Gevaert T, Everaert H et al (2012) Phase II study of helical tomotherapy in the multidisciplinary treatment of oligometastatic colorectal cancer. Radiat Oncol 7:34

    Article  PubMed  Google Scholar 

  26. Verellen D, De Ridder M, Linthout N et al (2007) Innovations in image-guided radiotherapy. Nat Rev Cancer 7:949–960

    Article  PubMed  CAS  Google Scholar 

  27. Engels B, Everaert H, Gevaert T et al (2011) Phase II study of helical tomotherapy for oligometastatic colorectal cancer. Ann Oncol 22:362–368

    Article  PubMed  CAS  Google Scholar 

  28. Langenhoff BS, Oyen WJ, Jager GJ et al (2002) Efficacy of fluorine-18-deoxyglucose positron emission tomography in detecting tumor recurrence after local ablative therapy for liver metastases: a prospective study. J Clin Oncol 20:4453–4458

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Instituto Madrileño de Oncología/Grupo IMO, 28010, Madrid, Spain

    C. V. Sole, J. L. Lopez Guerra, R. Matute, J. Jaen, F. Puebla, C. Beltran & H. Marsiglia

  2. Department of Radiation Oncology, Hospital General Universitario de Elche/ERESA, Elche, Spain

    E. Rivin

  3. Radiation Physics, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain

    A. Sanchez-Reyes

  4. Department of Radiation Oncology, Institut de Cancérologie Gustave Roussy, Villejuif, Paris, France

    C. Bourgier & H. Marsiglia

  5. Department of Oncology, Hospital General Universitario Gregorio Marañon, Madrid, Spain

    F. A. Calvo

Authors
  1. C. V. Sole
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. L. Lopez Guerra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Matute
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Jaen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Puebla
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. E. Rivin
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Sanchez-Reyes
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C. Beltran
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. C. Bourgier
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. F. A. Calvo
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. H. Marsiglia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. L. Lopez Guerra.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sole, C.V., Lopez Guerra, J.L., Matute, R. et al. Stereotactic ablative radiotherapy delivered by image-guided helical tomotherapy for extracranial oligometastases. Clin Transl Oncol 15, 484–491 (2013). https://doi.org/10.1007/s12094-012-0956-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-012-0956-2

Keywords

Search

Navigation