title: Phase II study of stereotactic body radiotherapy to primary tumor and metastatic locations in oligometastatic nonsmall-cell lung cancer patients.
abstract: BACKGROUND
  Stereotactic body radiotherapy (SBRT) has emerged as a treatment modality in patients presenting with oligometastatic nonsmall-cell lung cancer (NSCLC). SBRT is used as a local consolidative treatment to metastatic disease sites. The majority of patients included in SBRT trials for oligometastatic NSCLC have controlled primary tumors and brain metastases.
  
  
  METHODS
  Oligometastatic NSCLC patients with ≤5 metastatic lesions were included in a prospective phase II trial to evaluate efficacy and toxicity of SBRT to all disease sites, primary tumor and metastatic locations. SBRT to a dose of 50 Gy in 10 fractions was delivered. Positron emission tomography-computed tomography (PET-CT) was carried out at baseline and 3 months after SBRT to evaluate the metabolic response rate according to PET Response Criteria in Solid Tumors (PERCIST). The progression-free survival (PFS) and overall survival (OS) were calculated using Kaplan-Meier method from start of chemotherapy or radiotherapy. Side-effects were scored using the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) version 3.0.
  
  
  RESULTS
  Twenty-six patients received SBRT after induction chemotherapy (n = 17) or as a primary treatment (n = 9). Median follow-up was 16.4 months. Overall metabolic response rate was 60% with seven patients (30%) achieving a complete metabolic remission and 7 (30%) a partial metabolic response. Any acute grade 2 toxicity was observed in four patients (15%) and grade 3 pulmonary toxicity in two patients (8%). Median PFS and OS were 11.2 and 23 months. The 1-year PFS and 1-year OS rate were 45% and 67%, respectively.
  
  
  CONCLUSIONS
  SBRT to all disease sites, primary tumor and metastatic locations, in oligometastatic NSCLC patients produced an acceptable median PFS of 11.2 months.
authors.affiliation: Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: ccollen@uzbrussel.be.
authors.forename: C
authors.initials: C
authors.lastname: Collen
authors.affiliation: Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Christian
authors.affiliation: Department of Medical Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Schallier
authors.affiliation: Department of Respiratory Medicine, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Meysman
authors.affiliation: Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Duchateau
authors.affiliation: Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Storme
authors.affiliation: Department of Radiation Oncology, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: De Ridder
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D011446:Prospective Studies; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: consolidation; oligometastatic NSCLC; stereotactic body radiotherapy; uncontrolled primary tumors