Skip to main content
Erschienen in: Journal of Gastrointestinal Cancer 4/2019

06.10.2018 | Original Research

Stereotactic Body Radiation Therapy (SBRT) Using CyberKnife in Oligometastatic Cancer Patients; Retrospective Evaluation, Single Institution Experience

verfasst von: Abdullah Alsuhaibani, Ahmed Elashwah, Abdullah Alkafi, Camelia Constantinescus, Faisal ALzorkany

Erschienen in: Journal of Gastrointestinal Cancer | Ausgabe 4/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

We retrospectively evaluate local control rate at 6 months and 1 year in oligometastatic cancer patients treated with SBRT using CyberKnife.

Methods

Total of 21 patients with 24 treatment sites from February 2014 till June 2017 who were treated with SBRT in our institution were included in this study.

Results

Eleven patients were males, 10 patients were females, median age at diagnosis was 63 years, and colorectal cancer is the most commonly diagnosed cancer in 18 patients. The abdomino-pelvic lymph nodes were the commonest treatment site in 11 (45.8%), average PTV volume of 46.4 cc. All the patients received SBRT with average (BED) of 97 GY, 7 treatment sites received BED of < 100GYgroup 1, and 17 received BED  100GY group 2. No reported G3 or G4 acute or chronic toxicity. The 6 months and 1 year local control (LC) were 95.8 and 88.2%, respectively. After a median follow-up of 16.8 months, 19(90.5%) patients were alive; among them, local progression was observed in 1 (4.1%) treatment site, while systemic progression in 4 (16.6%), and two (9.5%) patients died; they had both local and systemic failures. The 1-year local PFS rate was 82%. In univariate analysis, PTV volume was significantly correlated with LC rate at 6 months (p = 0.001), while the site of metastasis appeared to significantly correlate with PFS (p = 0.03).

Conclusion

SBRT using CyberKnife is feasible, safe, and effective treatment for oligometastatic sites. Six months and 1 year local control rate is 95.8 and 88.2% respectively in our patients cohort, treatment regimens with higher BED resulting in better 1-year local PFS, although it was not statistically significant. A larger cohort of patients and longer follow up is required for better evaluation.
Literatur
1.
Zurück zum Zitat Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol. 1995;13(1):8–10.CrossRef Hellman S, Weichselbaum RR. Oligometastases. J Clin Oncol. 1995;13(1):8–10.CrossRef
2.
Zurück zum Zitat Casiraghi M, De Pas T, Maisonneuve P, et al. A 10-year single-center experience on 708 lung metastasectomies: the evidence of the “international registry of lung metastases.”. J Thorac Oncol. 2011;6(8):1373–8.CrossRef Casiraghi M, De Pas T, Maisonneuve P, et al. A 10-year single-center experience on 708 lung metastasectomies: the evidence of the “international registry of lung metastases.”. J Thorac Oncol. 2011;6(8):1373–8.CrossRef
3.
Zurück zum Zitat Simmonds PC, Primrose JN. Colquitt JL, et al.Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer. 2006;94(7):982–99.CrossRef Simmonds PC, Primrose JN. Colquitt JL, et al.Surgical resection of hepatic metastases from colorectal cancer: a systematic review of published studies. Br J Cancer. 2006;94(7):982–99.CrossRef
4.
Zurück zum Zitat Salama JK, Hasselle MD, Chmura SJ, et al. Stereotactic body radiotherapy for multisite extracranial oligometastases: final report of a dose escalation trial in patients with 1 to 5 sites of metastatic disease. Cancer. 2012;118(11):2962–70.CrossRef Salama JK, Hasselle MD, Chmura SJ, et al. Stereotactic body radiotherapy for multisite extracranial oligometastases: final report of a dose escalation trial in patients with 1 to 5 sites of metastatic disease. Cancer. 2012;118(11):2962–70.CrossRef
5.
Zurück zum Zitat Milano MT, Katz AW, Muhs AG, Philip A, Buchholz DJ, Schell MC, et al. A prospective pilot study of curative-intent stereotactic body radiation therapy in patients with 5 or fewer oligometastatic lesions. Cancer. 2008;112(3):650–8.CrossRef Milano MT, Katz AW, Muhs AG, Philip A, Buchholz DJ, Schell MC, et al. A prospective pilot study of curative-intent stereotactic body radiation therapy in patients with 5 or fewer oligometastatic lesions. Cancer. 2008;112(3):650–8.CrossRef
6.
Zurück zum Zitat Ahmed KA, Stauder MC, Miller RC, Bauer HJ, Rose PS, Olivier KR, et al. Stereotactic body radiation therapy in spinal metastases. Int J Radiat Oncol Biol Phys. 2012;82(5):e803–9.CrossRef Ahmed KA, Stauder MC, Miller RC, Bauer HJ, Rose PS, Olivier KR, et al. Stereotactic body radiation therapy in spinal metastases. Int J Radiat Oncol Biol Phys. 2012;82(5):e803–9.CrossRef
7.
Zurück zum Zitat Shaw E, Scott C, Souhami L, Dinapoli R, Bahary JP, Kline R, et al. Radiosurgery for the treatment of previously irradiated recurrent primary brain tumors and brain metastases: initial report of radiation therapy oncology group protocol (90-05). Int J Radiat Oncol Biol Phys. 1996;34(3):647–54.CrossRef Shaw E, Scott C, Souhami L, Dinapoli R, Bahary JP, Kline R, et al. Radiosurgery for the treatment of previously irradiated recurrent primary brain tumors and brain metastases: initial report of radiation therapy oncology group protocol (90-05). Int J Radiat Oncol Biol Phys. 1996;34(3):647–54.CrossRef
8.
Zurück zum Zitat Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys. 2000;47(2):291–8.CrossRef Shaw E, Scott C, Souhami L, Dinapoli R, Kline R, Loeffler J, et al. Single dose radiosurgical treatment of recurrent previously irradiated primary brain tumors and brain metastases: final report of RTOG protocol 90-05. Int J Radiat Oncol Biol Phys. 2000;47(2):291–8.CrossRef
9.
Zurück zum Zitat Bhatnagar AK, Flickinger JC, Kondziolka D, Lunsford LD. Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat Oncol Biol Phys. 2006;64(3):898–903.CrossRef Bhatnagar AK, Flickinger JC, Kondziolka D, Lunsford LD. Stereotactic radiosurgery for four or more intracranial metastases. Int J Radiat Oncol Biol Phys. 2006;64(3):898–903.CrossRef
10.
Zurück zum Zitat Potters L, Kavanagh B, Galvin JM, Hevezi JM, Janjan NA, Larson DA, et al. American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) practice guideline for the performance of stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2010;76(2):326–32.CrossRef Potters L, Kavanagh B, Galvin JM, Hevezi JM, Janjan NA, Larson DA, et al. American Society for Therapeutic Radiology and Oncology (ASTRO) and American College of Radiology (ACR) practice guideline for the performance of stereotactic body radiation therapy. Int J Radiat Oncol Biol Phys. 2010;76(2):326–32.CrossRef
11.
Zurück zum Zitat Heinzerling JH, Anderson JF, Papiez L, Boike T, Chien S, Zhang G, et al. Four-dimensional computed tomography scan analysis of tumor and organ motion at varying levels of abdominal compression during stereotactic treatment of lung and liver. Int J Radiat Oncol Biol Phys. 2008;70(5):1571–8.CrossRef Heinzerling JH, Anderson JF, Papiez L, Boike T, Chien S, Zhang G, et al. Four-dimensional computed tomography scan analysis of tumor and organ motion at varying levels of abdominal compression during stereotactic treatment of lung and liver. Int J Radiat Oncol Biol Phys. 2008;70(5):1571–8.CrossRef
12.
Zurück zum Zitat Chen J, Morin O, Aubin M, Bucci MK, Chuang CF, Pouliot J. Dose-guided radiation therapy with megavoltage cone-beam CT. Br J Radiol. 2006;79(1):S87–98.CrossRef Chen J, Morin O, Aubin M, Bucci MK, Chuang CF, Pouliot J. Dose-guided radiation therapy with megavoltage cone-beam CT. Br J Radiol. 2006;79(1):S87–98.CrossRef
13.
Zurück zum Zitat Fowler JF. 21 years of biologically effective dose. Br J Radiol. 2010;83(991):554–68.CrossRef Fowler JF. 21 years of biologically effective dose. Br J Radiol. 2010;83(991):554–68.CrossRef
15.
Zurück zum Zitat Bilal H, Mahmood S, Rajashanker B,et al. Is radiofrequency ablation more effective than stereotactic ablative radiotherapy in patients with early stage medically inoperable non-small cell lung cancer?. 2012 Aug;15(2):258–65. doi:https://doi.org/10.1093/icvts/ivs179. Epub 2012 May 10.CrossRef Bilal H, Mahmood S, Rajashanker B,et al. Is radiofrequency ablation more effective than stereotactic ablative radiotherapy in patients with early stage medically inoperable non-small cell lung cancer?. 2012 Aug;15(2):258–65. doi:https://​doi.​org/​10.​1093/​icvts/​ivs179. Epub 2012 May 10.CrossRef
17.
Zurück zum Zitat Kamran A. Ahmed, MD and Javier F.et al. Stereotactic body radiotherapy in the management of oligometastatic disease. Cancer Control January 2016, Vol. 23, No. 1. Kamran A. Ahmed, MD and Javier F.et al. Stereotactic body radiotherapy in the management of oligometastatic disease. Cancer Control January 2016, Vol. 23, No. 1.
18.
Zurück zum Zitat Timmerman RD. An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin Radiat Oncol. 2008;18:215–22.CrossRef Timmerman RD. An overview of hypofractionation and introduction to this issue of seminars in radiation oncology. Semin Radiat Oncol. 2008;18:215–22.CrossRef
19.
Zurück zum Zitat Dunlap NE, Cai J, Biedermann GB, et al. Chest wall volume receiving 30 Gy predicts risk of severe pain and/or rib fracture after lung stereotactic body radiotherapy. Int. J. Radiat. Oncol., Biol., Phys. 2009;76:796–801.CrossRef Dunlap NE, Cai J, Biedermann GB, et al. Chest wall volume receiving 30 Gy predicts risk of severe pain and/or rib fracture after lung stereotactic body radiotherapy. Int. J. Radiat. Oncol., Biol., Phys. 2009;76:796–801.CrossRef
20.
Zurück zum Zitat Rusthoven KE, Kavanagh BD, Cardenes H, Stieber VW, Burri SH, Feigenberg SJ, et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol. 2009;27(10):1572–8.CrossRef Rusthoven KE, Kavanagh BD, Cardenes H, Stieber VW, Burri SH, Feigenberg SJ, et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for liver metastases. J Clin Oncol. 2009;27(10):1572–8.CrossRef
21.
Zurück zum Zitat Herfarth KK, Debus J, Lohr F, Bahner ML, Rhein B, Fritz P, et al. Stereotactic single-dose radiation therapy of liver tumors: results of a phase I/II trial. J Clin Oncol. 2001;19(1):164–70.CrossRef Herfarth KK, Debus J, Lohr F, Bahner ML, Rhein B, Fritz P, et al. Stereotactic single-dose radiation therapy of liver tumors: results of a phase I/II trial. J Clin Oncol. 2001;19(1):164–70.CrossRef
22.
Zurück zum Zitat Ricardi U, Filippi AR, Guarneri A, Ragona R, Mantovani C, Giglioli F, et al. Stereotactic body radiation therapy for lung metastases. Lung Cancer. 2012;75(1):77–81.CrossRef Ricardi U, Filippi AR, Guarneri A, Ragona R, Mantovani C, Giglioli F, et al. Stereotactic body radiation therapy for lung metastases. Lung Cancer. 2012;75(1):77–81.CrossRef
23.
Zurück zum Zitat Rusthoven KE, Kavanagh BD, Burri SH, Chen C, Cardenes H, Chidel MA, et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases. J Clin Oncol. 2009;27(10):1579–84.CrossRef Rusthoven KE, Kavanagh BD, Burri SH, Chen C, Cardenes H, Chidel MA, et al. Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases. J Clin Oncol. 2009;27(10):1579–84.CrossRef
24.
Zurück zum Zitat Wulf J, Haedinger U, Oppitz U, Thiele W, Mueller G, Flentje M. Stereotactic radiotherapy for primary lung cancer and pulmonary metastases: a noninvasive treatment approach in medically inoperable patients. Int J Radiat Oncol Biol Phys. 2004;60(1):186–96.CrossRef Wulf J, Haedinger U, Oppitz U, Thiele W, Mueller G, Flentje M. Stereotactic radiotherapy for primary lung cancer and pulmonary metastases: a noninvasive treatment approach in medically inoperable patients. Int J Radiat Oncol Biol Phys. 2004;60(1):186–96.CrossRef
25.
Zurück zum Zitat Fumagalli I, Bibault JE, Dewas S, Kramar A, Mirabel X, Prevost B, et al. A single-institution study of stereotactic body radiotherapy for patients with unresectable visceral pulmonary or hepatic oligometastases. Radiat Oncol. 2012;7:164.CrossRef Fumagalli I, Bibault JE, Dewas S, Kramar A, Mirabel X, Prevost B, et al. A single-institution study of stereotactic body radiotherapy for patients with unresectable visceral pulmonary or hepatic oligometastases. Radiat Oncol. 2012;7:164.CrossRef
26.
Zurück zum Zitat 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(1):112–8.CrossRef 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(1):112–8.CrossRef
27.
Zurück zum Zitat Takeda A, Kunieda E, Ohashi T, Aoki Y, Koike N, Takeda T. Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer. Radiother Oncol. 2011;101(2):255–9.CrossRef Takeda A, Kunieda E, Ohashi T, Aoki Y, Koike N, Takeda T. Stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal cancer and other primary cancers in comparison with primary lung cancer. Radiother Oncol. 2011;101(2):255–9.CrossRef
28.
Zurück zum Zitat Ricardi U, Filippi AR, Guarneri A, et al. Stereotactic body radiation therapy for lung metastases. Lung Cancer. 2012;75(1):77–81.CrossRef Ricardi U, Filippi AR, Guarneri A, et al. Stereotactic body radiation therapy for lung metastases. Lung Cancer. 2012;75(1):77–81.CrossRef
29.
Zurück zum Zitat Ahmed KA, Berglund AE, Hoffe SE, et al. Differences between colon cancer primaries and metastases utilizing a molecular assay for tumor radiosensitivity suggest implications for potential oligometastatic SBRT patient selection. Int J Radiat Oncol Biol Phys. 2015;92(4):837–42.CrossRef Ahmed KA, Berglund AE, Hoffe SE, et al. Differences between colon cancer primaries and metastases utilizing a molecular assay for tumor radiosensitivity suggest implications for potential oligometastatic SBRT patient selection. Int J Radiat Oncol Biol Phys. 2015;92(4):837–42.CrossRef
30.
Zurück zum Zitat Rainer J. Klement radiobiological parameters of liver and lung metastases derived from tumor control data of 3719 metastases. Radiother Oncol. 2017;123:218–26.CrossRef Rainer J. Klement radiobiological parameters of liver and lung metastases derived from tumor control data of 3719 metastases. Radiother Oncol. 2017;123:218–26.CrossRef
Metadaten
Titel
Stereotactic Body Radiation Therapy (SBRT) Using CyberKnife in Oligometastatic Cancer Patients; Retrospective Evaluation, Single Institution Experience
verfasst von
Abdullah Alsuhaibani
Ahmed Elashwah
Abdullah Alkafi
Camelia Constantinescus
Faisal ALzorkany
Publikationsdatum
06.10.2018
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Cancer / Ausgabe 4/2019
Print ISSN: 1941-6628
Elektronische ISSN: 1941-6636
DOI
https://doi.org/10.1007/s12029-018-0170-8

Weitere Artikel der Ausgabe 4/2019

Journal of Gastrointestinal Cancer 4/2019 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.