Potentially curative stereotactic body radiation therapy (SBRT) for single or oligometastasis to the lung

Figures & data

Table I. Patient characteristics.

Characteristics		Number of patients (%)
Age	<60	16 (28)
	≥60	41 (72)
Gender	Male	49 (86)
	Female	8 (14)
Performance	0–1	51 (90)
	2	6 (10)
Primary tumor^†	Lung	33 (50)
	Liver	9 (14)
	Colorectum	7 (10)
	Head & neck	11 (16)
	Others	7 (10)
Histology	SQ	25 (44)
	AD	17 (30)
	Others	15 (26)
The presence of extrathoracic disease	Yes	5 (9)
	No	52 (91)
Disease-free interval	<1 year	24 (42)
	≥1 and <2 years	18 (32)
	≥2 years	15 (26)
Number of lung metastasis	1	50 (87)
	2	5 (9)
	3	1 (2)
	4	1 (2)
Tumor size^†	<2.5 cm	58 (87)
	≥2.5 cm	9 (13)
4D-CT	Yes	30 (52)
	No	27 (48)
RT dose^†	50 Gy/ 5 fx's	4 (6)
	60 Gy/ 5 fx's	44 (66)
	60 Gy/ 4 fx's	19 (28)

AD, adenocarcinoma; 4D CT, four-dimensional computed tomography; RT, radiotherapy; SQ, squamous cell carcinoma.

^†number of lesions.

Figure 1. Actuarial local control rates (A) and overall survival rates (B) for all patients.

Figure 2. Actuarial local control rates according to (A) tumor size and (B) primary tumor.

Table II. Analysis of factors affecting local control rate.

	Number of lesions
Variables	Local progression	Local control	Crude local control rate (%)	p-value^†
Primary tumor
Lung	0	33	100.0	0.04
Liver	2	7	77.8
Colorectum	1	6	85.7
Head & neck	0	11	100.0
Others	0	7	100.0
Histology
SQ	0	27	100.0	0.210
AD	1	21	95.5
Others	2	16	88.9
Size of tumor
<2.5 cm	1	57	98.3	0.006
≥2.5 cm	2	7	77.8
RT dose
50 Gy/5 fx's	0	4	100.0	0.440
60 Gy/5 fx's	3	41	93.2
60 Gy/4 fx's	0	19	100.0
RT response
CR	1	16	94.1	0.751
PR	2	38	95.0
SD	0	10	100.0

AD, adenocarcinoma; CR, complete response; PR, partial response; RT, radiotherapy; SQ, squamous cell carcinoma; SD, stable disease.

^†χ² test.

Figure 3. Factors affecting overall survival (OS).

Table III. Treatment outcomes of SBRT for metastatic lung tumors in recently published study.

Study	No. of lesions	Origin of primary tumor	Total dose/Fraction number	BED (Gy10)	Local control rate
Hamamoto et al. [10]	12	Colorectum (58%)	48 Gy/4 Fx's	105.6 Gy10	25.0% at 2 years
Kim et al. [15]	18	Colorectum (100%)	39–51 Gy/3 Fx's	89.7 Gy10 to 137.7 Gy10	52.7% at 3 years
Takeda et al. [16]	44	Colorectum (48%)	50 Gy/5 Fx's	100 Gy10	82.2% at 2 years
Norihisa et al. [11]	43	Lung (44%)	48–60 Gy/4–5 Fx's	105.6 Gy10 to 132 Gy10	90.0% at 2 years
Rusthoven et al. [12]	63	Colorectum (24%)	48–60 Gy/3 Fx's	124 Gy10 to 180 Gy10	96.0% at 2 years
McCammon et al. [13]	165^+	Not reported	54–60 Gy/3 Fx's	151 Gy10 to 180 Gy10	89.8% at 3 years
The present study	67	Lung (50%)	50–60 Gy/4–5 Fx's	100 Gy10 to 150 Gy10	94.5% at 3 years

BED(Gy10), biologically effective dose (alpha-beta = 10); SBRT, stereotactic body radiation therapy.

⁺The proportion of metastatic lung tumors is not demonstrated.

Hamamoto Y, Kataoka M, Yamashita M, Shinkai T, Kubo Y, Sugawara Y, . Local control of metastatic lung tumors treated with SBRT of 48 Gy in four fractions: In comparison with primary lung cancer. Jpn J Clin Oncol 2010;40:125–9.

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Kim MS, Yoo SY, Cho CK, Yoo HJ, Choi CW, Seo YS, . Stereotactic body radiation therapy using three fractions for isolated lung recurrence from colorectal cancer. Oncology 2009;76:212–9.

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McCammon R, Schefter TE, Gaspar LE, Zaemisch R, Gravdahl D, Kavanagh B. Observation of a dose-control relationship for lung and liver tumors after stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys 2009; 73:112–8.

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