The Role of Radiation Therapy in Oligometastasis to Lung and Liver Metastasis
Keywords:
radiation therapy, stereotactic body radiation therapy, oligometastasisAbstract
Some 60%–70% of cancer patients suffer metastasis. Oligometastasis refers to metastatic disease with limited volume usually five or fewer metastatic lesions. Curative use of surgical metastasectomy has been based on non-randomized evidence, especially for isolated lung and liver metastases, with phase III randomized control trials limited to select sites, such as surgical resection plus radiotherapy (RT) for solitary brain metastases compared with RT alone. Stereotactic Body Radiation Therapy (SBRT) is a highly conformal RT modality delivered at high doses per fraction; it has been shown to be safe in treating oligometastases. Although randomized studies for SBRT in oligometastases are limited, a recently published phase II study showed significant improvement in progression-free survival with local consolidative therapy after initial systemic therapy in patients with colorectal carcinoma and non-small cell lung carcinoma. Several ongoing randomized phase III studies are evaluating the use of SBRT in oligometastatic disease. Early detection and aggressive local treatment, such as surgery or RT, can improve progression-free and overall survival without increased complications for cancer patients with oligometastases.are summarized.
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