title: Once-weekly stereotactic radiotherapy for patients with oligometastases: compliance and preliminary efficacy.
abstract: OBJECTIVE
  This retrospective analysis reports the outcomes obtained with an original once-weekly stereotactic radiotherapy fractionation given to patients affected by evolving oligometastases from different solid malignancies.
  
  
  METHODS
  From 2009 to 2011, patients with symptomatic and/or evolving oligometastases were submitted to a median 5-fraction cycle of stereotactic radiotherapy of one fraction per week in order to exploit a radiobiological rationale designed to increase the therapeutic index. Individual fractionation was mainly planned according to patient performance status, oligometastasis size and site, and record of previous irradiation in the same site.
  
  
  RESULTS
  Thirty-six patients in stage IV UICC-TNM affected by oligometastases were treated with image-guided intensity-modulated stereotactic tomotherapy with a single weekly radiation. Median age was 70 years (range, 34-89). The median weekly single dose, number of fractions and overall total radiation dose were 7 Gy, 5 fractions and 35 Gy, respectively. Thirty-five (97%) patients completed the treatment schedule. No patient suffered mild or severe radiation-related side effects. Twenty-one (87%) of 24 patients with local pain had complete symptomatic response within 30 days following the end of radiotherapy. Local control assessed at imaging after stereotactic radiotherapy was evidenced in 30 (83%) patients. Median time to response after the end of radiotherapy was 40 days.
  
  
  CONCLUSIONS
  The original radiotherapy regimen delivering only a single stereotactic dose per week seems to be highly feasible with an interesting high efficacy rate in patients with oligometastases from different solid tumors. Overall, the once-weekly treatment was very compliant in an advanced cancer stage especially for elderly and frail patients.
authors.affiliation: Department of Radio-Oncology, IRCCS AOU San Martino, IST, National Institute for Cancer Research, Genoa, Italy. renzo.corvo@unige.it
authors.forename: Renzo
authors.initials: R
authors.lastname: Corvò
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lamanna
authors.forename: Stefano
authors.initials: S
authors.lastname: Vagge
authors.forename: Liliana
authors.initials: L
authors.lastname: Belgioia
authors.forename: Davide
authors.initials: D
authors.lastname: Bosetti
authors.forename: Deborah
authors.initials: D
authors.lastname: Aloi
authors.forename: Giorgia
authors.initials: G
authors.lastname: Timon
authors.forename: Almalina
authors.initials: A
authors.lastname: Bacigalupo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004067:Digestive System Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D016330:Frail Elderly; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D016634:Radiosurgery / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies