title: Risk factors and management of oligometastatic non-small cell lung cancer.
abstract: Non-small cell lung cancer (NSCLC) is an aggressive malignancy with close to half of all patients presenting with metastatic disease. A proportion of these patients with limited metastatic disease, termed oligometastatic disease, have been shown to benefit from a definitive treatment approach. Synchronous and metachronous presentation of oligometastatic disease have prognostic significance, with current belief that metachronous disease is more favorable. Surgical excision of intracranial and extracranial oligometastatic disease has been shown to improve survival, especially in patients with lymph node-negative disease, adenocarcinoma histology and smaller thoracic tumors. Definitive radiation to sites of oligometastatic disease and initial thoracic disease has also been shown to have a similar impact on survival for both intracranial and extracranial disease. Recent studies have reported on the use of targeted agents combined with ablative doses of radiation in the oligometastatic setting with promising outcomes. In this review, we present the historical and current literature describing surgical and radiation treatment options for patients with oligometastatic NSCLC.
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
authors.forename: Akshar N
authors.initials: AN
authors.lastname: Patel
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Simone
authors.affiliation: Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, 195 Little Albany Street, Room 2038, New Brunswick, NJ 08901 USA jabbousk@cinj.rutgers.edu.
authors.forename: Salma K
authors.initials: SK
authors.lastname: Jabbour
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D009362:Neoplasm Metastasis; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000628:therapy; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D013534:Survival
keywords: SABR; SBRT; non-small cell lung; oligometastasis; radiosurgery