title: Linac-based stereotactic body radiotherapy for oligometastatic patients with single abdominal lymph node recurrent cancer.
abstract: OBJECTIVE
  To evaluate stereotactic body radiotherapy (SBRT) for single abdominal lymph node cancer recurrence.
  
  
  METHODS
  Inclusion criteria for this retrospective study were as follows: adult oligometastatic cancer patients with single abdominal lymph node recurrence that underwent SBRT but not other local therapy, written informed consent for treatment. Previous radiotherapy or concomitant systemic therapy were allowed. Toxicity and tumor response were evaluated using Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer Scale and Response Evaluation Criteria in Solid Tumors.
  
  
  RESULTS
  Sixty-nine patients (94 lesions) underwent SBRT (median 24 Gy/3 fractions). Primary diagnosis included urological, gastrointestinal, gynecologic, and other malignancies. Concomitant systemic therapy was performed in 35 cases. Median follow-up was 20 months. Two grade 3 acute and 1 grade 4 late toxicity events were registered. Complete radiologic response, partial response, stabilization, and progressive disease were observed in 36 (44%), 21 (26%), 20 (25%), and 4 (5%) lesions, respectively, out of 81 evaluable lesions. Response rates were similar when analysis was restricted to lesions treated with exclusive SBRT (no concomitant therapy). Actuarial 3-year in-field progression-free interval, progression-free survival and overall-survival rates were 64.3%, 11.7%, and 49.9%, respectively. Overall-survival rates were significantly higher in favorable histology cases (prostate and kidney tumors). Pattern of failure was predominantly out-field.
  
  
  CONCLUSIONS
  SBRT is a feasible approach for single abdominal lymph node recurrence, offering excellent in-field tumor control with low-toxicity profile. Future studies are warranted to identify the patients that benefit most from this treatment. The optimal combination with systemic treatment should also be defined.
authors.affiliation: Departments of *Radiotherapy §Medical Physics #Urology, European Institute of Oncology ∥CNAO Foundation, National Center for Oncological Hadrontherapy †University of Milan ¶Department of Bioengineering, Politecnico di Milano, Milan ‡Division of Radiotherapy, IRCCS Multimedia. Sesto S. Giovanni and Multimedica Holding, Castellanza, Italy.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Jereczek-Fossa
authors.forename: Gaia
authors.initials: G
authors.lastname: Piperno
authors.forename: Sara
authors.initials: S
authors.lastname: Ronchi
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Catalano
authors.forename: Cristiana
authors.initials: C
authors.lastname: Fodor
authors.forename: Raffaella
authors.initials: R
authors.lastname: Cambria
authors.forename: Piero
authors.initials: P
authors.lastname: Fossati Ing
authors.forename: Federica
authors.initials: F
authors.lastname: Gherardi
authors.forename: Daniela
authors.initials: D
authors.lastname: Alterio
authors.forename: Dario
authors.initials: D
authors.lastname: Zerini
authors.forename: Cristina
authors.initials: C
authors.lastname: Garibaldi
authors.forename: Guido
authors.initials: G
authors.lastname: Baroni
authors.forename: Ottavio
authors.initials: O
authors.lastname: De Cobelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Orecchia
mesh_terms: D000008:Abdominal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000556:secondary*; D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000528:radiation effects; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D016634:Radiosurgery / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome