Stereotactic body radiation therapy in the treatment of cancer patients with oligometastatic disease: a real world study

Purpose Stereotactic body radiation therapy (SBRT) is a treatment modality with curative intent for oligometastatic cancer patients, commonly defined by a low-burden metastatic disease with 1–5 systemic metastases. Better knowledge of the clinical profile and prognostic factors in oligometastatic cancer patients could help to improve the selection of candidates who may obtain most benefits from SBRT. The objective of this study was to describe the clinical data and outcome in term of overall survival (OS) of patients with oligometastatic disease treated with SBRT over a 6-year period. Methods From 2013 to 2018, 284 solid tumor cancer patients with 1–5 oligometastases underwent SBRT at a large university-affiliated oncological center in Barcelona, Spain. Variables related to the patient profile, tumor, oligometastatic disease, and treatment were evaluated. Results A total of 327 metastatic tumors were treated with SBRT. In 65.5% of cases, metachronous tumors were diagnosed at least 1 year after diagnosis of the primary tumor. The median age of the patients was 73.9 years and 66.5% were males. The median follow-up was 37.5 months. The most common primary tumors were lung and colorectal cancer, with lung and bone as the most commonly treated metastatic sites. Ninety-three percent of patients showed a Karnofsky score (KPS) between 80 and 100. Adenocarcinoma was the most common histological type. The median overall survival was 53.4 months, with 1-, 2- and 5-year survival rates of 90.5%, 73.9% and 43.4%, respectively. Overall survival rates of breast (67.6 months, 95% CI 56.4–78.9), urological (63.3 months, 95% CI 55.8–70.8), and colorectal (50.8 months, 95% CI 44.2–57.4) tumors were higher as compared with other malignancies (20 months, 95% CI 11.2–28.8 months) (p < 0.001) (AU)

[Impact of age and comorbidity on survival and toxicity of irradiated prostate cancer patients]. / Impacto de la edad y de la comorbilidad en la supervivencia y toxicidad del paciente con cáncer de próstata irradiado.

BACKGROUND AND OBJECTIVE: We intended to assess the impact of age on radiation outcome in patients treated for prostate cancer with 2D planning radiation therapy in clinical practice at the Hospital Clínic of Barcelona Radiation Oncology Department. PATIENTS AND METHOD: One hundred eighty three patients, treated from November 1993 to April 1999, were included. Median follow-up was 41.8 months and median age was 70 years old. Median dose to prostate was 70 Gy. Univariate (Kaplan-Meier with log rank test comparison) and multivariate analysis (Cox's regression models) were done to assess the effect of age on toxicity and to study prognostic factors for disease control, survival and radiation treatment toxicity. RESULTS: Five years disease free survival probability was 61.94%, with an overall survival probability of 82.83%. Although comorbidity increased significantly with age, reduced overall survival by a factor of 0.4, from 94.85% to 78.55% at 5 years. No differences were seen with regard to age in acute or late toxicity. Five years toxicity free probability was 66.46%. CONCLUSIONS: Comorbidities decrease life expectancy in prostate cancer patients treated with radiation. Age does not necessarily suppose an increased risk of late toxicity for selected patients.

Impacto de la edad y de la comorbilidad en la supervivencia y toxicidad del paciente con cáncer de próstata irradiado / Impact of age and comorbidity on survival and toxicity of irradiated prostate cancer patients

Fundamento y objetivo: Determinar la influencia de la edad en el momento del diagnóstico en la evolución clínica de los pacientes tratados con radioterapia en 2 dimensiones en el Hospital Clínic de Barcelona por un cáncer de próstata. Pacientes y método: Se incluyó a 183 pacientes tratados desde noviembre de 1993 hasta abril de 1999. La mediana de seguimiento fue de 41,8 meses y la mediana de la edad se situó en los 70 años. La dosis mediana administrada a la próstata fue de 70 Gy. Se realizaron análisis univariado (Kaplan-Meier, comparación mediante rangos logarítmicos) y multivariado (modelos de regresión de Cox) para valorar la influencia de la edad en la toxicidad y el estudio de factores pronóstico para el control de la enfermedad, supervivencia y toxicidad. Resultados: La supervivencia libre de enfermedad alcanzó un 61,94% a los 5 años, con una supervivencia global del 82,83%. La comorbilidad, que se incrementó significativamente con la edad, redujo la supervivencia global en un factor de 0,4, de modo que pasó del 94,85 al 78,55% a los 5 años. La probabilidad de estar libre de toxicidad a los 5 años fue del 66,46%, sin observar diferencias significativas en función de la edad. Conclusiones: La comorbilidad reduce la esperanza de vida de los pacientes tratados con radioterapia por un cáncer de próstata. La edad no incrementa necesariamente la toxicidad

Background and objective: We intended to assess the impact of age on radiation outcome in patients treated for prostate cancer with 2D planning radiation therapy in clinical practice at the Hospital Clínic of Barcelona Radiation Oncology Department. Patients and method: One hundred eighty three patients, treated from November 1993 to April 1999, were included. Median follow-up was 41.8 months and median age was 70 years old. Median dose to prostate was 70 Gy. Univariate (Kaplan-Meier with log rank test comparison) and multivariate analysis (Cox's regression models) were done to assess the effect of age on toxicity and to study prognostic factors for disease control, survival and radiation treatment toxicity. Results: Five years disease free survival probability was 61.94%, with an overall survival probability of 82.83%. Although comorbidity increased significantly with age, reduced overall survival by a factor of 0.4, from 94.85% to 78.55% at 5 years. No differences were seen with regard to age in acute or late toxicity. Five years toxicity free probability was 66.46%. Conclusions: Comorbidities decrease life expectancy in prostate cancer patients treated with radiation. Age does not necessarily suppose an increased risk of late toxicity for selected patients