PMID- 33069796 OWN - NLM STAT- MEDLINE DCOM- 20210721 LR - 20210721 IS - 1879-355X (Electronic) IS - 0360-3016 (Print) IS - 0360-3016 (Linking) VI - 109 IP - 3 DP - 2021 Mar 1 TI - Safety, Efficacy, and Patterns of Failure After Single-Fraction Stereotactic Body Radiation Therapy (SBRT) for Oligometastases. PG - 756-763 LID - S0360-3016(20)34399-6 [pii] LID - 10.1016/j.ijrobp.2020.10.011 [doi] AB - PURPOSE: Fewer attendances for radiation therapy results in increased efficiency and less foot traffic within a radiation therapy department. We investigated outcomes after single-fraction (SF) stereotactic body radiation therapy (SBRT) in patients with oligometastatic disease. METHODS AND MATERIALS: Between February 2010 and June 2019, patients who received SF SBRT to 1 to 5 sites of oligometastatic disease were included in this retrospective study. The primary objective was to describe patterns of first failure after SBRT. Secondary objectives included overall survival (OS), progression-free survival (PFS), high-grade treatment-related toxicity (Common Terminology Criteria for Adverse Events grade >/=3), and freedom from systemic therapy (FFST). RESULTS: In total, 371 patients with 494 extracranial oligometastases received SF SBRT ranging from 16 Gy to 28 Gy. The most common primary malignancies were prostate (n = 107), lung (n = 63), kidney (n = 52), gastrointestinal (n = 51), and breast cancers (n = 42). The median follow-up was 3.1 years. The 1-, 3-, and 5-year OS was 93%, 69%, and 55%, respectively; PFS was 48%, 19%, and 14%, respectively; and FFST was 70%, 43%, and 35%, respectively. Twelve patients (3%) developed grade 3 to 4 treatment-related toxicity, with no grade 5 toxicity. As the first site of failure, the cumulative incidence of local failure (irrespective of other failures) at 1, 3 and 5 years was 4%, 8%, and 8%, respectively; locoregional relapse at the primary was 10%, 18%, and 18%, respectively; and distant failure was 45%, 66%, and 70%, respectively. CONCLUSIONS: SF SBRT is safe and effective, and a significant proportion of patients remain FFST for several years after therapy. This approach could be considered in resource-constrained or bundled-payment environments. Locoregional failure of the primary site is the second most common pattern of failure, suggesting a role for optimization of primary control during metastasis-directed therapy. CI - Copyright (c) 2020 Elsevier Inc. All rights reserved. FAU - Sogono, Paolo AU - Sogono P AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Bressel, Mathias AU - Bressel M AD - Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - David, Steven AU - David S AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Shaw, Mark AU - Shaw M AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Chander, Sarat AU - Chander S AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Chu, Julie AU - Chu J AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Plumridge, Nikki AU - Plumridge N AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Byrne, Keelan AU - Byrne K AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Hardcastle, Nicholas AU - Hardcastle N AD - Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Kron, Tomas AU - Kron T AD - Department of Physical Sciences, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. FAU - Wheeler, Greg AU - Wheeler G AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia. FAU - Hanna, Gerard G AU - Hanna GG AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. FAU - MacManus, Michael AU - MacManus M AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. FAU - Ball, David AU - Ball D AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. FAU - Siva, Shankar AU - Siva S AD - Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia. Electronic address: Shankar.Siva@petermac.org. LA - eng PT - Journal Article DEP - 20201015 PL - United States TA - Int J Radiat Oncol Biol Phys JT - International journal of radiation oncology, biology, physics JID - 7603616 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - COVID-19/epidemiology MH - Female MH - Humans MH - Male MH - Middle Aged MH - Neoplasm Metastasis/*radiotherapy MH - Neoplasms/radiotherapy/surgery MH - Pandemics MH - Progression-Free Survival MH - Radiation Injuries/pathology MH - Radiosurgery/adverse effects/*methods MH - Radiotherapy Dosage MH - Retrospective Studies MH - Salvage Therapy MH - Treatment Failure MH - Young Adult PMC - PMC7560377 EDAT- 2020/10/19 06:00 MHDA- 2021/07/22 06:00 PMCR- 2020/10/15 CRDT- 2020/10/18 20:25 PHST- 2020/06/27 00:00 [received] PHST- 2020/09/07 00:00 [revised] PHST- 2020/10/09 00:00 [accepted] PHST- 2020/10/19 06:00 [pubmed] PHST- 2021/07/22 06:00 [medline] PHST- 2020/10/18 20:25 [entrez] PHST- 2020/10/15 00:00 [pmc-release] AID - S0360-3016(20)34399-6 [pii] AID - 10.1016/j.ijrobp.2020.10.011 [doi] PST - ppublish SO - Int J Radiat Oncol Biol Phys. 2021 Mar 1;109(3):756-763. doi: 10.1016/j.ijrobp.2020.10.011. Epub 2020 Oct 15.