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Multi-Institutional Retrospective Analysis of the Outcomes of Proton Beam Therapy for Patients With 1 to 3 Pulmonary Oligometastases From Various Primary Cancers
- Source :
- Advances in Radiation Oncology, Vol 6, Iss 4, Pp 100690-(2021), Advances in Radiation Oncology
- Publication Year :
- 2021
- Publisher :
- Elsevier, 2021.
-
Abstract
- Purpose Our purpose was to evaluate the efficacy of proton beam therapy (PBT) in patients with 1 to 3 pulmonary oligometastases from various primary cancers in Japan. Methods and Materials This multi-institutional retrospective survey included 118 patients with 141 metastatic lung tumors from miscellaneous primary cancers, across 6 Japanese institutions, and involved the analyses of local progression-free rate (LPF), distant progression-free rate, progression-free survival rate, cause-specific survival rate, and overall survival rate (OS). Treatment-induced adverse effects of grade ≥2 were evaluated according to the Common Terminology Criteria for Adverse Events (version 4.0). Cox proportional hazards regression models were used in univariable analysis and multivariable analysis (MVA) for the identification of the prognostic factors of LPF and OS. Results The median follow-up duration from the time of PBT was 25.5 months. The major primary disease sites included colorectal cancer (42.4%), lung cancer (11.9%), head and neck cancer (8.5%), and kidney cancer (8.5%). For years 1, 2, and 3, LPFs were 92.2%, 86.3%, and 78.4%; distant progression-free rates were 59.1%, 44.1%, and 34.0%; progression-free survival rates were 49.6%, 31.7%, and 24.2%; cause-specific survival rates were 83.4%, 72.5%, and 64.8%; and OS rates were 79.0%, 67.8%, and 59.6%, respectively. Eight patients developed acute adverse effects (grade ≥2). Ten patients developed radiation pneumonitis (grade 2) as a late adverse effect. None of the patients developed severe late toxicity (grade ≥3). Colorectal cancer as the primary disease was the only prognostic factor associated with LPF that remained independently significant in the MVAs performed using 3 sets of parameters (hazard ratio [HR], 3.31-4.76 in 3 MVA sets). In the MVA, the significant prognostic factors for OS were performance status (HR, 2.78; 95% confidence interval, 1.01-7.67) and total tumor volume (HR, 1.01; 95% confidence interval, 1.00-1.02). Conclusions PBT provides promising outcomes for pulmonary oligometastasis with acceptable toxicities.
- Subjects :
- Oncology
medicine.medical_specialty
R895-920
030218 nuclear medicine & medical imaging
03 medical and health sciences
Medical physics. Medical radiology. Nuclear medicine
0302 clinical medicine
Internal medicine
medicine
Radiology, Nuclear Medicine and imaging
Clinical Investigation
Lung cancer
Adverse effect
Survival rate
RC254-282
Performance status
business.industry
Hazard ratio
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Common Terminology Criteria for Adverse Events
medicine.disease
Late Adverse Effect
030220 oncology & carcinogenesis
business
Kidney cancer
Subjects
Details
- Language :
- English
- ISSN :
- 24521094
- Volume :
- 6
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Advances in Radiation Oncology
- Accession number :
- edsair.doi.dedup.....f25679d32d4beaa08e423477015c2066