Palliative Care

PV QA 3 - Poster Viewing Q&A 3

TU_31_3046 - Oligometastases - New Era of Cancer Therapy?

Tuesday, October 23
1:00 PM - 2:30 PM
Location: Innovation Hub, Exhibit Hall 3

Oligometastases – New Era of Cancer Therapy?
A. Napieralska, W. Majewski, and L. Miszczyk; Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland

Purpose/Objective(s): The aim of the study is to evaluate treatment result of cancer patients (pts) with oligometastatic disease. Additional identification of prognostic and predictive factors was also performed.

Materials/Methods: Inclusion criteria were: histological confirmation of cancer, one to three metastases (mets), except brain mets, stereotactic radiotherapy (SBRT) as local treatment of metastatic lesion, at least one follow-up (FU) visit. Group consisted of 542 consecutive cancer pts (186 female, 356 male; age 21-85, median 66) treated in 2004 – 2017 with SBRT due to 698 mets, including 241 lung (35%), 227 lymph node (32%), 106 bone (15%), 105 liver (15%) and 19 adrenal/soft tissue mets (3%). Median time to develop mets was 21 months after the primary diagnosis (range 0-315). Majority (91%) received primary radical treatment. SBRT total dose ranged from 6 to 60 Gy (median 36) delivered in fractions of 5 to 20 Gy (median 12). In statistical analysis Kaplan - Meier method, log rank test and multivariate Cox regression model were used.

Results: Follow-up (FU) ranged from 0.3 to 28.8 years (median 14.2) from primary diagnosis, from 0.3 to 17.2 years (median 6.6) from mets diagnosis and 0.1 to 9.8 years from mets SBRT (median 5.6). Five-, 10-, and 15-year overall survival (OS) was 81%, 61% and 46%, respectively. Local control after SBRT was achieved in 91% pts and remained stable to the end of FU in 80%. Other mets occurred in 51% of pts after SBRT. Multivariate analysis showed that time of mets detection (oligometastases vs oligorecurrence, p=0.000), age (p=0.03), type of treatment of primary tumor (radical vs palliative, p=0.000), location of mets (p=0.002) and performance status (p=0.001) are significant factors influencing OS. Patients in oligometastatic group had 5-year OS from SBRT of 37% compared to 58% in oligorecurrence group (p=0.0003). Lung and gastrointestinal cancer pts are those who benefit the most from implementation of radical therapy in primary treatment (p=0.000 and 0.003, respectively). SBRT responders with liver and lymph node mets had better OS (p=0.0002 and 0.0099, respectively) and those with liver, bone and lung mets had improved PFS (p=0.0001, 0.011 and 0.003, respectively) compared to non-responders. Type of primary treatment (p=0.000), type of cancer (p=0.04) and performance status (p=0.02) were significant factors influencing PFS after SBRT in multivariate analysis. Type of cancer (p=0.006), location of mets (p=0.013) and presence of other than treated with SBRT mets (p=0.026) were significant factors influencing LC after SBRT in multivariate analysis. LC and PFS was better in pts with SBRT total dose over 50 Gy (p=0.008 and 0.0008, respectively).

Conclusion: Primary radical treatment of oligometastatic cancer pts in SBRT mets group improved OS and PFS, and should be applied in those in good performance status. Patients with oligometastases had inferior OS compared to oligorecurrence group.

Author Disclosure: A. Napieralska: None. W. Majewski: None.

Aleksandra Napieralska, MD, PhD

Institute of Oncology Gliwice Branch


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TU_31_3046 - Oligometastases - New Era of Cancer Therapy?

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