دورية أكاديمية
أعرض في EDS

Radioresistant Pulmonary Oligometastatic and Oligoprogressive Lesions From Nonlung Primaries: Impact of Histology and Dose-Fractionation on Local Control After Radiation Therapy.

التفاصيل البيبلوغرافية
العنوان: Radioresistant Pulmonary Oligometastatic and Oligoprogressive Lesions From Nonlung Primaries: Impact of Histology and Dose-Fractionation on Local Control After Radiation Therapy.
المؤلفون: Verma N; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Laird JH; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Moore NS; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Hayman TJ; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Housri N; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Peters GW; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Knowlton CA; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Jairam V; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Campbell AM; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut., Park HS; Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut.
المصدر: Advances in radiation oncology [Adv Radiat Oncol] 2024 Mar 21; Vol. 9 (6), pp. 101500. Date of Electronic Publication: 2024 Mar 21 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101677247 Publication Model: eCollection Cited Medium: Print ISSN: 2452-1094 (Print) Linking ISSN: 24521094 NLM ISO Abbreviation: Adv Radiat Oncol Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Philadelphia, PA] : Elsevier Inc., [2016]-
مستخلص: Purpose: We investigated whether pulmonary metastases from historically considered radioresistant primaries would have inferior local control after radiation therapy than those from nonradioresistant nonlung primaries, and whether higher biologically effective dose assuming alpha/beta=10 (BED10) would be associated with superior local control.
Methods and Materials: We identified patients treated with radiation therapy for oligometastatic or oligoprogressive pulmonary disease to 1 to 5 lung metastases from nonlung primaries in 2013 to 2020 at a single health care system. Radioresistant primary cancers included colorectal carcinoma, endometrial carcinoma, renal cell carcinoma, melanoma, and sarcoma. Nonradioresistant primary cancers included breast, bladder, esophageal, pancreas, and head and neck carcinomas. The Kaplan-Meier estimator, log-rank test, and multivariable Cox proportional hazards regression were used to compare local recurrence-free survival (LRFS), new metastasis-free survival, progression-free survival, and overall survival.
Results: Among 114 patients, 73 had radioresistant primary cancers. The median total dose was 50 Gy (IQR, 50-54 Gy) and the median number of fractions was 5 (IQR, 3-5). Median follow-up time was 59.6 months. One of 41 (2.4%) patients with a nonradioresistant metastasis experienced local failure compared with 18 of 73 (24.7%) patients with radioresistant metastasis (log-rank P = .004). Among radioresistant metastases, 12 of 41 (29.2%) patients with colorectal carcinoma experienced local failure compared with 6 of 32 (18.8%) with other primaries (log-rank P = .018). BED10 ≥100 Gy was associated with decreased risk of local recurrence. On univariable analysis, BED10 ≥100 Gy (hazard ratio [HR], 0.263; 95% CI, 0.105-0.656; P = .004) was associated with higher LRFS, and colorectal primary (HR, 3.060; 95% CI, 1.204-7.777; P = .019) was associated with lower LRFS, though these were not statistically significant on multivariable analysis. Among colorectal primary patients, BED10 ≥100 Gy was associated with higher LRFS (HR, 0.266; 95% CI, 0.072-0.985; P = .047) on multivariable analysis.
Conclusions: Local control after radiation therapy was encouraging for pulmonary metastases from most nonlung primaries, even for many of those classically considered to be radioresistant. Those from colorectal primaries may benefit from testing additional strategies, such as resection or systemic treatment concurrent with radiation.
Competing Interests: Henry S. Park reports consulting, personal honoraria, and being on an advisory board of AstraZeneca; personal honoraria from Bristol Myers Squibb, Daichii Sankyo, and G1 Therapeutics; being on the advisory board of Galera and Regeneron; institutional research funding from Merck; consulting and institutional research funding from RefleXion.
(© 2024 The Author(s).)
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تواريخ الأحداث: Date Created: 20240503 Latest Revision: 20240504
رمز التحديث: 20240504
مُعرف محوري في PubMed: PMC11063223
DOI: 10.1016/j.adro.2024.101500
PMID: 38699671
قاعدة البيانات: MEDLINE
الوصف
تدمد:2452-1094
DOI:10.1016/j.adro.2024.101500