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Colciago RR, Chissotti C, Ferrario F, Belmonte M, Purrello G, Faccenda V, Panizza D, Canova S, Passarella G, Cortinovis DL, Arcangeli S. Time to Next Treatment Following Sub-Ablative Progression Directed Radiation Therapy for Oligoprogressive Non-Small-Cell Lung Cancer. Curr Oncol 2024; 31:6840-6852. [PMID: 39590136 PMCID: PMC11592685 DOI: 10.3390/curroncol31110505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2024] [Revised: 10/25/2024] [Accepted: 10/28/2024] [Indexed: 11/28/2024] Open
Abstract
We aimed to evaluate whether progression-directed radiation therapy (PDRT) can prolong the initiation of a subsequent systemic therapy regimen in a cohort of patients with oligoprogressive NSCLC. A retrospective analysis was conducted on NSCLC patients who underwent PDRT for extracranial oligoprogressive NSCLC, defined as limited (up to five) progressing lesions following initial complete, partial, or stable response to systemic therapy according to REC1ST 1.1 and/or PERCIST 1.0 criteria. Cox proportional hazard regressions were performed to identify factors influencing time to next treatment (TTNT), which was considered the primary endpoint. Forty patients were analyzed. First, second, and ≥3 lines of systemic therapy were administered in 22 (58.2%), 14 (27.2%), and 4 (14.6%) cases, respectively. The median total dose was 36 Gy (range: 12-60) in five fractions (1-10), with a median biological effective dose for tumor control (BED10) of 52 Gy (26.4-151.2). After a median follow-up of 11 months (2-50), PDRT delayed further systemic therapy in 32 (80.0%) treatments. Median TTNT was not reached at 8 months (1-47) with a one-year Kaplan-Meier estimate of 81.4% (95% CI: 75.0% to 87.8%). No >grade 3 adverse event was observed. On multivariate analysis, patients with ≥3 lines of systemic therapy and/or with larger CTV volumes did not benefit from PDRT. Despite the use of sub-ablative doses, our findings show that PDRT represents an effective, safe, and viable option for oligoprogressive NSCLC. Patients irradiated early during their systemic treatment course, with a low volume of disease and nonmetastatic oligoprogression, could derive substantial benefits from PDRT.
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Affiliation(s)
- Riccardo Ray Colciago
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
| | - Chiara Chissotti
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
- Radiation Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (D.P.)
| | - Federica Ferrario
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
- Radiation Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (D.P.)
| | - Maria Belmonte
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
- Radiation Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (D.P.)
| | - Giorgio Purrello
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
- Radiation Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (D.P.)
| | - Valeria Faccenda
- Radiation Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (D.P.)
- Medical Physics Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Denis Panizza
- Radiation Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (D.P.)
- Medical Physics Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy
| | - Stefania Canova
- Medical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Gaia Passarella
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
- Medical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Diego Luigi Cortinovis
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
- Medical Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy;
| | - Stefano Arcangeli
- Medicine and Surgery Department, University of Milan Bicocca, 20126 Milano, Italy; (R.R.C.); (C.C.); (M.B.); (G.P.); (G.P.); (D.L.C.); (S.A.)
- Radiation Oncology Unit, Fondazione IRCCS San Gerardo dei Tintori, 20900 Monza, Italy; (V.F.); (D.P.)
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Shor D, Khoo V, Jayaprakash KT. Advancing the Paradigm: Oligometastatic Disease and the Impact of Stereotactic Ablative Body Radiotherapy. Clin Oncol (R Coll Radiol) 2024; 36:402-405. [PMID: 38631977 DOI: 10.1016/j.clon.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 03/13/2024] [Accepted: 03/21/2024] [Indexed: 04/19/2024]
Affiliation(s)
- D Shor
- Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK.
| | - V Khoo
- The Royal Marsden Hospital NHS Foundation Trust, London, UK; Institute of Cancer Research, London, UK
| | - K T Jayaprakash
- Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, Kings Lynn, UK
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Thippu Jayaprakash K, Hanna GG, Hatton MQ. Lung Cancer in 2022 and Beyond! Clin Oncol (R Coll Radiol) 2022; 34:695-697. [PMID: 36153212 DOI: 10.1016/j.clon.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/02/2022] [Indexed: 01/31/2023]
Affiliation(s)
- K Thippu Jayaprakash
- Oncology Centre, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Department of Oncology, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK.
| | - G G Hanna
- Cancer Centre, Belfast City Hospital, Belfast, UK; Queen's University Belfast, Belfast, UK
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