Palliative Care

SS 10 - Palliative 2

72 - Patient Reported-Quality of Life in Oligometastatic Cancer Treated With SBRT: Interim Report of a Phase II Multicenter Clinical Trial

Monday, October 22
7:55 AM - 8:05 AM
Location: Room 007 C/D

Patient Reported-Quality of Life in Oligometastatic Cancer Treated With SBRT: Interim Report of a Phase II Multicenter Clinical Trial
P. Sutera1, D. A. Clump II2, R. Kalash3, D. D'Ambrosio4, A. M. Mihai5, H. Wang6, D. Petro7, S. A. Burton8, and D. E. Heron9; 1University of Pittsburgh School of Medicine, Pittsburgh, PA, 2UPMC Hillman Cancer Center, Department of Radiation Oncology, Pittsburgh, PA, 3Department of Radiation Oncology, Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, 4New Jersey Cyberknife, Toms River, NJ, 5Beacon Hospital, Dublin, Ireland, 6University of Pittsburgh, Pittsburgh, PA, 7UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA, 8Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA, 9UPMC Hillman Cancer Center, Pittsburgh, PA

Purpose/Objective(s): Oligometastatic disease has emerged as a potentially curable state in the process of cancer progression where aggressive local therapy renders improved oncologic outcomes. Stereotactic body radiation therapy (SBRT) can deliver highly-conformal, doses of radiation to the target lesions while minimizing dose to normal surrounding tissues in an approach that can be integrated with systemic therapy for patients with a limited number of metastatic lesions. Herein we report the initial oncologic outcomes and patient-reported quality of life (PR-QoL) from a phase II multicenter trial for patients with recurrent oligometastatic disease.

Materials/Methods: Patients with a pathologically proven-diagnosis of a solid malignancy with recurrent oligometastatic disease (1-5 metastases ≤3 organs) were prospectively recruited between 2011-2017. SBRT dose and fractionation was dependent upon the lesion location and tumor size consistent with ablative doses of radiation. Patient follow-up occurred within 6 weeks of completion of SBRT and every 3 months for 3 years. Patients received FACT-G questionnaire at baseline and at each follow-up to assess for PR-QoL. Total Fact-G scores were compared to baseline using Wilcoxon signed rank test. Median follow-up was calculated by reverse Kaplan-Meier method. Overall survival (OS), local progression-free survival (LPFS), and distant progression-free survival (DPFS) were calculated using Kaplan-Meier estimation to either date of last follow-up/death or local/distant failure.

Results: We enrolled 147 patients with recurrent oligometastatic cancer. Median age at time of enrollment was 66.4 years (IQR: 59.9-74.6). The most common primary tumors included: lung (21.8%, NSCLC: n=29, SCLC: n=3), colorectal adenocarcinoma (21.1%), and head & neck (12.2%, SCC: n=11). Patients were treated with SBRT to either 1 (70.7%), 2 (19.0%), 3 (6.8%), 4 (0.7%), or 5 metastatic sites (2.7%). In a median follow-up of 41.3 months (IQR: 14.6-59.0), the median OS was 42.3 months (95% CI: 27.4-infinity) with 5-year OS of 43%. Median OS was 26.8 months (95% CI: 8.1-45.4), 54.4 months (95% CI: incalculable), and 19.8 months (95% CI: 1.8-16.2) for lung, colorectal, and H&N. At 5-years LPFS and DPFS were 75% and 17% respectively. Acute grade 2+ and grade 3+ toxicity was 7.5% and 2.0%, respectively and late grade 2+ and grade 3+ toxicity both 1.4%. Acute grade 3 toxicity included dyspnea (n=1), dermatitis (n=1), and anemia (n=1). Late toxicity included grade 3 ureter obstruction (n=1) and grade 4 small bowel obstruction (n=1). There was no significant change in quality of life at completion, 6 weeks, 3, and 9 months after treatment. At 6 and 12 months patients were found to have statistically significant improvement in PR-QoL.

Conclusion: This multi-center prospective phase II study demonstrates SBRT for recurrent oligometastatic cancer is a feasible and tolerable treatment option with minimal acute and late grade 3+ toxicity, and initially associated with improved PR-QoL.

Author Disclosure: P. Sutera: None. D.A. Clump: None. D. D'Ambrosio: None. H. Wang: None. D. Petro: None. S.A. Burton: None. D.E. Heron: No personal compensation; Accuray Exchange in Radiation Oncology. Partnership; Cancer Treatment Services International. Vice Chairman of Clinical Affairs; University of Pittsburgh School of Medicine. Director of Radiation Services; UPMC CancerCenter.

Philip Sutera, BS

University of Pittsburgh

Disclosure:
No relationships to disclose.

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72 - Patient Reported-Quality of Life in Oligometastatic Cancer Treated With SBRT: Interim Report of a Phase II Multicenter Clinical Trial

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