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• W3094179536 abstract "Data regarding SBRT in non-spine bone metastases is limited. We present a large multi-institutional analysis of outcomes and predictors for local recurrence (LR), widespread progression, and overall survival (OS) in oligometastatic (OM) patients treated with SBRT to non-spine bone metastases. Patients treated with SBRT at 6 international institutions from 2007 – 2016 were reviewed. OM was defined as 5 or fewer cumulative extracranial metastases at time of first SBRT. Oligoprogressive events were recorded until widespread progression or death. Patient demographics, treatment characteristics, and disease progression assessments were collected retrospectively. Competing risks analysis was used to estimate cumulative incidence of LR and widespread progression. OS was estimated by the Kaplan-Meier method. Fine and Gray competing risks regression was used to analyze univariate and multivariable relationships between clinical and treatment factors with LR. 163 patients with 228 non-spine bone lesions are reported. The median follow-up was 24 mos (range 13-37). The most common primary histologies were prostate (44.2%), NSCLC (16.6%), breast (11.7%), and renal cell (RCC, 9.8%). The median total dose was 35Gy (range 15-50) delivered in a median of 5 fractions (range 1-10). Median PTV was 31.9cc (range 4.8-1002.4). The estimated cumulative incidence of LR was 5.0%, 8.5%, and 14.1% at 6 months, 1 year, and 2 years, respectively. Univariate analysis identified RCC (HR 8.02, p<0.001) and NSCLC (HR 2.69, p = 0.025) histologies as predictors of LR, while prostate histology (HR 0.13, p<0.001) correlated with better local control. Increasing PTV (HR 1.03 per 10cc increase, p<0.001), soft tissue extension (HR 2.81, p = 0.011), re-irradiation (HR 3.91, p = 0.039), and PTV ≥32cc (HR 9.15, p<0.001) predicted for LR. No significant association was found between BED10, dose to PTV, or MRI target delineation and LR. Location of metastasis did not significantly predict for LR, including long bone vs. other. Multivariate analysis confirmed RCC histology (HR 2.94, p = 0.013), prostate histology (HR 0.26, p = 0.015), and PTV ≥32cc (HR 4.87, p = 0.015) as significant independent correlates of LR. The cumulative incidence of widespread progression at 6 months, 1 year, and 2 years following SBRT was 19.4%, 29.3%, and 43.0%, respectively, and the median time to widespread progression was 35.9 mos (range 0-83.5). OS at 2 years post-SBRT was 74.8%, and the median OS was not reached. Three patients (1.8%) had recorded grade 3 fracture toxicity. This large multi-institutional series of SBRT to non-spine bone metastases demonstrates an excellent 2-year local control rate of 85% with a mature median follow up of 2 years. Larger PTVs and RCC histology predicted for LR, while prostate histology correlated with better local control. A median time to widespread progression of 3 years was observed, which underscores the importance of this treatment paradigm for OM disease." @default.
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• W3094179536 date "2020-11-01" @default.
• W3094179536 modified "2023-10-16" @default.
• W3094179536 title "SBRT for Oligometastatic Non-Spine Bone Metastases: A Multi-Institutional Study" @default.
• W3094179536 doi "https://doi.org/10.1016/j.ijrobp.2020.07.1356" @default.
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