open access

Vol 20, No 6 (2015)
Special Issue Papers
Published online: 2015-11-01
Submitted: 2014-06-04
Get Citation

Is Stereotactic Body Radiotherapy (SBRT) in lymph node oligometastatic patients feasible and effective?

Barbara Alicja Jereczek-Fossa, Sara Ronchi, Roberto Orecchia
DOI: 10.1016/j.rpor.2014.10.004
·
Rep Pract Oncol Radiother 2015;20(6):472-483.

open access

Vol 20, No 6 (2015)
Special Issue Papers
Published online: 2015-11-01
Submitted: 2014-06-04

Abstract

Objectives

To review the available data about stereotactic body-radiotherapy (SBRT) for oligometastatic lymph node cancer recurrence.

Methods

The inclusion criteria for this study were as follows: Medline search for the (1) English language (2) full paper (abstracts were excluded) on (3) adult oligometastatic solid cancer recurrence limited to lymph node that underwent SBRT (4) outcome data available and (5) published up to the 30th April 2014.

Results

38 papers fulfilling the inclusion criteria have been found: 7 review articles and 31 patient series (20 and 11 retrospective and prospective studies, respectively) including between 1 and 69 patients (636 lymph nodes). Twelve articles reported only lymph node SBRT while in 19 – all types of SBRT including lymph node SBRT were presented. Two-year local control, 4-year progression free survival and overall survival was of up to 100%, 30% and 50%, respectively. The progression was mainly out-field (10–30% of patients had a recurrence in another lymph node/nodes). The toxicity was low with mainly mild acute events and single grade 3–4 late events. When compared to SBRT for any oligometastatic cancer, SBRT for lymph node recurrence carried better prognosis and showed lower toxicity.

Conclusions

SBRT is a feasible approach for oligometastatic lymph node recurrence, offering excellent in-field tumor control with low toxicity profile. The potential abscopal effect has been hypothesized as a basis of these findings. Future studies are warranted to identify the patients that benefit most from this treatment. The optimal combination with systemic treatment should also be defined.

Abstract

Objectives

To review the available data about stereotactic body-radiotherapy (SBRT) for oligometastatic lymph node cancer recurrence.

Methods

The inclusion criteria for this study were as follows: Medline search for the (1) English language (2) full paper (abstracts were excluded) on (3) adult oligometastatic solid cancer recurrence limited to lymph node that underwent SBRT (4) outcome data available and (5) published up to the 30th April 2014.

Results

38 papers fulfilling the inclusion criteria have been found: 7 review articles and 31 patient series (20 and 11 retrospective and prospective studies, respectively) including between 1 and 69 patients (636 lymph nodes). Twelve articles reported only lymph node SBRT while in 19 – all types of SBRT including lymph node SBRT were presented. Two-year local control, 4-year progression free survival and overall survival was of up to 100%, 30% and 50%, respectively. The progression was mainly out-field (10–30% of patients had a recurrence in another lymph node/nodes). The toxicity was low with mainly mild acute events and single grade 3–4 late events. When compared to SBRT for any oligometastatic cancer, SBRT for lymph node recurrence carried better prognosis and showed lower toxicity.

Conclusions

SBRT is a feasible approach for oligometastatic lymph node recurrence, offering excellent in-field tumor control with low toxicity profile. The potential abscopal effect has been hypothesized as a basis of these findings. Future studies are warranted to identify the patients that benefit most from this treatment. The optimal combination with systemic treatment should also be defined.

Get Citation

Keywords

Stereotactic body radiotherapy; Oligometastatic cancer; Recurrent cancer; Lymph nodes

About this article
Title

Is Stereotactic Body Radiotherapy (SBRT) in lymph node oligometastatic patients feasible and effective?

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 20, No 6 (2015)

Pages

472-483

Published online

2015-11-01

DOI

10.1016/j.rpor.2014.10.004

Bibliographic record

Rep Pract Oncol Radiother 2015;20(6):472-483.

Keywords

Stereotactic body radiotherapy
Oligometastatic cancer
Recurrent cancer
Lymph nodes

Authors

Barbara Alicja Jereczek-Fossa
Sara Ronchi
Roberto Orecchia

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl