Abstract
Simple SummaryStereotactic body radiation therapy (SBRT) is currently used to treat lung metastasis, particularly in the setting of oligometastatic disease. Objective of this treatment is lesion’s ablation. However, its techniques, efficacy, and safety remain to be evaluated. Several teams have published their experiences with different radiotherapy schedules. The aim of this review was to analyze these topics in regard to the last five years of publications. For this purpose, we carried out a systematic review of the literature using the PRISMA method. This review can help oncologists involved in lung oligometastasis to clarify their knowledge through the wealth of published data and may lead to improved management.For several years, oligometastatic disease has represented an intermediate state between localized disease accessible to local treatment and multimetastatic disease requiring systemic therapy. The lung represents one of the most common metastatic locations. Stereotactic body radiation therapy (SBRT) appears to be the treatment of choice for these patients. There are few data defining the place of radiotherapy and reporting outcome after SBRT in lung metastases. This 5-year review aimed to determine areas of SBRT usefulness and methods for the management of pulmonary metastasis in oligometastatic patients. A search for articles on PubMed allowed selection of the most relevant studies. Eighteen articles were selected according to pre-established criteria for this purpose. The analysis concludes that SBRT is an effective and safe treatment in selected patients when the disease remains localized from one to three organs.
Highlights
For several years, Hellman and Weichselbaum described oligometastatic disease evolution as involving a low number of metastases in only a few organs [1]
We collected the number of patients, their gender, age, number of irradiated pulmonary metastases, period of inclusion, the “oligometastatic” definition used by the authors, size of the lesions, primary tumor, metachronous or synchronous nature of the lesions, exclusive lung oligometastatic state, complications rate, and follow-up time, as well as local control (LC) and overall survival (OS) or progression-free survival (PFS) rates
The optimal physical dose to reach a high probability of LC is unknown, but this review suggests that a 10 GyBED of 100 Gy could be proposed to increase the LC [19,23,25,29]
Summary
Hellman and Weichselbaum described oligometastatic disease evolution as involving a low number of metastases in only a few organs [1]. The definitions have varied from one to five metastases in one to three sites [2,3,4]. Some studies have suggested that life expectancy could be longer for these patients compared with those with more spread out disease [5,6]. Some studies have shown that local treatments can improve overall survival [2,7]. SABR-COMET, a recent phase II study, investigated the effect of stereotactic body radiation therapy (SBRT) on oligometastatic patients’ survival. SBRT was associated with an improvement in overall survival compared with palliative standard of care treatments alone [2]
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