Abstract
ObjectivesThe present study aims to evaluate long-term side-effects and outcomes and confirm prognostic factors after stereotactic body radiotherapy (SBRT) of pulmonary lesions. This is the first work that combines the investigated data from patient charts and patient-reported outcome (PRO) up to 14 years after therapy.Materials and methodsWe analyzed 219 patients and 316 lung metastases treated between 2004 and 2019. The pulmonary lesions received a median dose and dose per fraction of 35 Gy (range: 14–60.5 Gy) and 8 Gy (range: 3–20 Gy) to the surrounding isodose. During the last 1.5 years of monitoring, we added PRO assessment to our follow-up routine. We sent an invitation to a web-based survey questionnaire to all living patients whose last visit was more than 6 months ago.ResultsMedian OS was 27.6 months. Univariate analysis showed a significant influence on OS for KPS ≥90%, small gross tumor volume (GTV) and planning target volume (PTV), the absence of external metastases, ≤3 pulmonary metastases, and controlled primary tumor. The number of pulmonary metastases and age influenced local control (LC) significantly.During follow-up, physicians reported severe side-effects ≥ grade 3 in only 2.9% within the first 6 months and in 2.5% after 1 year. Acute symptomatic pneumonitis grade 2 was observed in 9.7%, as grade 3 in 0.5%.During PRO assessment, 39 patients were contacted, 38 patients participated, 14 participated twice during follow-up. Patients reported 15 cases of severe side effects (grade ≥ 3) according to PROCTCAE classification. Severe dyspnea (n = 6) was reported mostly.ConclusionWe could confirm excellent local control and low toxicity rates. PROs improve and complement follow-up care. They are an essential measure in addition to the physician-reported outcomes. Future research must be conducted regarding the correct interpretation of PRO data.
Highlights
Lung metastases represent one of the largest groups of metastases
Univariate analysis showed a significant influence on overall survival (OS) for Karnofsky Performance Score (KPS) ≥90%, small gross tumor volume (GTV) and planning target volume (PTV), the absence of external metastases, ≤3 pulmonary metastases, and controlled primary tumor
Future research must be conducted regarding the correct interpretation of patient-reported outcome (PRO) data
Summary
Lung metastases represent one of the largest groups of metastases. They can be found in more than 50% of cancer patients [1]. Whereas for patients with aggressive metastatic spread, systemic therapy remains the treatment of choice for patients with a low metastatic burden, referred to as oligometastatic (OM) disease, local treatment is favored. In cases where surgery cannot be performed due to the irresectability of the tumor, insufficient medical patient conditions, or patient refusal, stereotactic body radiation therapy (SBRT) reveals a noninvasive alternative treatment [2,3,4,5,6]. Based on the emerging data on SBRT, it can even be considered equieffective as a local treatment alternative to surgery [7]. Keeping in mind that SBRT is non-invasive, quick initiation of systemic treatment is possible
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
