Aitken, K., Tree, A., Thomas, K., Nutting, C., Hawkins, M., Tait, D., Mandeville, H., Ahmed, M., Lalondrelle, S., Miah, A., Taylor, A., Ross, G., Khoo, V., van As, N. (2015) Initial UK Experience of Stereotactic Body Radiotherapy for Extracranial Oligometastases: Can We Change the Therapeutic Paradigm? CLINICAL ONCOLOGY, 27 (7). pp. 411-419. ISSN 0936-6555

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Abstract

Aims: To retrospectively review the toxicity and early outcome data from patients who have received stereotactic body radiotherapy (SBRT) for extracranial oligometastases at a single UK institution. Materials and methods: Eligible patients had <= 3 extracranial metastases and performance status <= 2. Prior systemic therapy and radical treatment of oligometastastic relapse with any standard treatment modality was permitted. Patients with synchronous metastatic disease were excluded unless they had evidence of controlled primary disease after radical therapy. Follow-up consisted of clinical examination, biochemical and radiological assessments in accordance with standard clinical care. Progression events were defined using RECIST. Toxicity was evaluated using CTCAE v4.0. Local control, progression-free survival (PFS), freedom from widespread distant metastasis (defined as disease not amenable to further radical salvage therapy) and overall survival were calculated. Results: Between July 2011 and April 2014, 73 patients with 87 metastases received SBRT (range 1-3 per patient). The median follow-up was 14.5 months (range 0-26.4). The median PFS was 14.5 months (1 year PFS 57%, 2 year 28%); 1 year overall survival 96%, 2 year 79.8%; 2 year local control 88%. At 2 years, 46% of patients were free from widespread distant metastases. No >= grade 3 acute or late toxicity was observed. Conclusion: At this time point, observed toxicity is minimal with excellent local control rates. This promising treatment paradigm requires further investigation in the context of a randomised controlled trial to establish if the addition of SBRT to standard care improves survival outcomes. (C) 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Item Type:	Article
Authors (ICR Faculty only):	Khoo, Vincent and Nutting, Chris
All Authors:	Aitken, K., Tree, A., Thomas, K., Nutting, C., Hawkins, M., Tait, D., Mandeville, H., Ahmed, M., Lalondrelle, S., Miah, A., Taylor, A., Ross, G., Khoo, V., van As, N.
Additional Information:	ISI Document Delivery No.: CJ7LJ Times Cited: 0 Cited Reference Count: 34 Aitken, K. Tree, A. Thomas, K. Nutting, C. Hawkins, M. Tait, D. Mandeville, H. Ahmed, M. Lalondrelle, S. Miah, A. Taylor, A. Ross, G. Khoo, V. van As, N. Cridlan Trust; NHS We acknowledge NHS funding to the Royal Marsden NIHR Biomedical Research Centre. Dr Katharine Aitken received funding from the Cridlan Trust. Elsevier science london London
Uncontrolled Keywords:	Extracranial oligometastases SBRT stereotactic radiotherapy radiation-therapy prostate-cancer lung-cancer phase-ii metastases trial tumors hypofractionation establishment liver
Research teams:	Clinical Units > Head & Neck Cancer Unit Clinical Units > Urology Unit
Depositing User:	Alexander Smithson
Date Deposited:	25 Jun 2015 11:03
Last Modified:	25 Jun 2015 11:03
URI:	http://publications.icr.ac.uk/id/eprint/14194

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