title: The role of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in the elderly.
abstract: OBJECTIVE
  To report about clinical outcome of stereotactic body radiation therapy (SBRT) in the treatment of oligometastatic disease in elderly patients.
  
  
  METHODS
  Patients with 1-4 inoperable metastases were treated with SBRT. Dose prescription ranged from 40 to 75 Gy in 3-8 fractions. SBRT was delivered using the volumetric modulated arc therapy technique with flattening filter-free photon beams. The primary end points were in-field local control (LC) and toxicity. Secondary end points were overall survival (OS) and disease-specific survival (DSS).
  
  
  RESULTS
  82 patients with 111 total metastases were treated. Median age was 79 years. 64 patients (78%) had a single lesion; the remaining patients had 2-4 lesions. 16 (14.4%) lesions were localized in the abdomen, 50 (45.0%) in the liver and 45 (40.5%) in the lungs. Local response was observed for 87 lesions (78.4%) while local progression was observed in 24 lesions (21.6%). Actuarial 1-year LC was 86.8% ± 3.3%. Actuarial 1-year OS was 93.6% ± 2.7%. 2-year findings were 76.3% ± 4.4% and 72.0% ± 5.6%, respectively. Actuarial 1- and 2-year DSS results were 97.5% ± 2.0% and 81.6% ± 4.9%, respectively. Treatment-related Grade 2-3 toxicity was observed in five patients (4.2%); Grade 1 toxicity in seven patients (5.9%) and no toxicity was observed in 85.4% of the cases.
  
  
  CONCLUSIONS
  SBRT is a safe and effective therapeutic option for the treatment of oligometastatic disease in the elderly with acceptable rates of LC and low treatment-related toxicity.
  
  
  CONCLUSIONS
  The use of SBRT for oligometastatic disease in the elderly can be considered as a valuable approach, particularly for patients with fragile status or refusing other approaches.
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Scorsetti
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Clerici
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Piera
authors.initials: P
authors.lastname: Navarria
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Agostino
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Piergallini
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Fiorenza
authors.initials: F
authors.lastname: De Rose
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Ascolese
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Tozzi
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Iftode
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Villa
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Tiziana
authors.initials: T
authors.lastname: Comito
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Ciro
authors.initials: C
authors.lastname: Franzese
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Mancosu
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Tomatis
authors.affiliation: Departments of Radiotherapy and Radiosurgery, Oncology, Liver Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cozzi
mesh_terms: D000008:Abdominal Neoplasms / Q000556:secondary / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D011832:Radiation Injuries / Q000517:prevention & control; D016634:Radiosurgery / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome