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Poster Display session (Friday) (ID 65)
- Event: ELCC 2018
- Type: Poster Display session
- Presentations: 1
- Coordinates: 4/13/2018, 12:30 - 13:00, Hall 1
207P - A comparison of outcomes of stereotactic body radiotherapy versus metastasectomy in patients with pulmonary metastases (ID 541)
12:30 - 13:00 | Author(s): K.M. Kang
Since the concept of oligometastases was proposed, several investigators have suggested that aggressive local treatment of oligometastatic disease may be helpful in improving patient survival. However, optimal local therapy is still not clear it is difficult to compare the treatment outcomes of SBRT vs. metastasectomy in prospective randomized trials. Hence, the aim of this study was to compare the efficacy of SBRT and metastasectomy for the treatment of pulmonary metastases. Additionally, we sought to identify patients who are most likely to benefit from local treatment.
Total 51 patients (median age, 65 years) were included. Twenty-one patients received SBRT using the Cyberknife system (total radiation doses 48–60 Gy delivered in 3–5 equal fractions) and 30 underwent metastasectomy, most (93.3%) with wedge resection. The median follow-up duration was 13.7 months. Local control rate, progression free survival (PFS), and overall survival (OS) were assessed.
The median tumor size was larger in the SBRT group (2.5 cm) than in the metastasectomy group (1.25 cm; P = 0.015). Other synchronous metastases were prevalent in the SBRT group (57.1% vs. 20%; P = 0.006). The local control rate was similar in both groups (P = 0.163). PFS was longer in patients who underwent metastasectomy than in those who received SBRT (P = 0.02), with 1- and 2-year PFS rates of 51.1% and 46% in the former vs. 23.8% and 11.9% in the latter, respectively. The corresponding OS rates were 95% and 81.8% vs. 79.5% and 68.2%, respectively (P = 0.534). On multivariate analysis, synchronous metastasis was associated with poor PFS, and tumor size was the most significant factor influencing OS. There were no differences in PFS and OS between the metastasectomy and SBRT groups after dividing patients according to the presence or absence of synchronous metastases.
SBRT and metastasectomy for pulmonary metastases produce similar local control and OS outcomes. SBRT is effective and has a broader indication than metastasectomy; however, patients with synchronous metastases are less likely to benefit from local treatment, whether via SBRT or surgery.
Clinical trial identification:
Legal entity responsible for the study:
Has not received any funding
All authors have declared no conflicts of interest.