TY - JOUR
T1 - Conditional Survival of Patients With Extracranial Oligometastatic Treated With Stereotactic Body Radiation Therapy
T2 - An International Consortium Study
AU - Chen, Hanbo
AU - Badellino, Serena
AU - Biswas, Tithi
AU - Dagan, Roi
AU - Erler, Darby
AU - Foote, Matthew
AU - Poon, Ian
AU - Redmond, Kristin J.
AU - Ricardi, Umberto
AU - Sahgal, Arjun
AU - Louie, Alexander V.
N1 - Funding Information:
This work was supported by grant funding from Elekta AB. The funding source had no influence on the study design, data collection, analysis, interpretation, or preparation of the manuscript for this study. Disclosures: I.P., D.E., and R.D. report travel support from Elekta AB through the Consortium for Oligometastases Research. T.B. reports travel support from Elekta AB through the Consortium for Oligometastases Research and honoraria from Galera Therapeutics. K.J.R. reports travel support from Elekta AB through the Consortium for Oligometastases Research, travel support from Brainlab and Accuray, research funding from Accuray, honoraria from Accuray and National Comprehensive Cancer Network, research funding from Canon, travel support from icotec, and participation on a Data Safety Monitoring Board for Biomimetix. U.R. reports honoraria from Accuray for lectures and from AstraZeneca for serving on a speaker's bureau. A.S. reports travel support from Elekta AB through the Consortium for Oligometastases Research and from Varian and Brainlab; research funding from Elekta AB and Varian; consulting fees from Varian (Medical Advisory Group), Elekta (Gamma Knife Icon), and Brainlab; honoraria from AstraZeneca, Elekta AB, Varian, Brainlab, and Medtronic Kyphon; board membership for the International Stereotactic Radiosurgery Society; and cochairmanship for the AO Spine Knowledge Forum Tumor. A.V.L. reports honoraria from AstraZeneca, RefleXion, and Varian. No other disclosures were reported.
Funding Information:
This work was supported by grant funding from Elekta AB. The funding source had no influence on the study design, data collection, analysis, interpretation, or preparation of the manuscript for this study.
Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Purpose: Prolonged survivorship is increasingly observed in patients with oligometastases (OM) treated with stereotactic body radiation therapy (SBRT). The purpose of this study was to study the conditional survival of patients with OM, which can provide more detailed prognostic information over time by considering time already survived. Methods and Materials: A multi-institutional database consisting of 1033 patients with OM (≤5 metastases) treated with SBRT between 2006 and 2017 was analyzed. Conditional overall survival (OS) and progression-free survival (PFS) in 3 years were obtained at multiple time points for all patients and by primary cancer type. Cox regression was used to determine trends in conditional OS and PFS. Changes in the predictors of OS and PFS over time were also determined by multivariable Cox regression. Results: The median follow-up was 24 months (0.3-105 months). Three-year OS and PFS at baseline were 56.7% and 23.2%, respectively. The OS in 3 years conditional on having survived for 3, 6, 12, and 24 months did not significantly change over time (56.7%, 55.4%, 55.8%, and 50.6%, respectively; P =.60). In contrast, the probability of PFS in 3 years conditional on having survived progression-free for 3, 6, 12, and 24 months significantly increased over time (23.6%, 27.3%, 35.1%, and 48.8%, respectively; P <.001). When stratified by primary site, conditional PFS significantly increased over time for patients with colorectal, breast, or kidney cancer. Conditional OS remained stable for patients with non-small cell lung cancer or kidney cancer but significantly decreased over time for patients with prostate, breast, or colorectal cancer. Changes in significant prognostic factors of OS and PFS over time were also observed. Conclusions: Analysis of conditional survival among patients with OM showed that as patients survived longer, their prognosis for further survival remained stable or decreased. However, patients who survived longer without disease progression had increased probability of PFS over time.
AB - Purpose: Prolonged survivorship is increasingly observed in patients with oligometastases (OM) treated with stereotactic body radiation therapy (SBRT). The purpose of this study was to study the conditional survival of patients with OM, which can provide more detailed prognostic information over time by considering time already survived. Methods and Materials: A multi-institutional database consisting of 1033 patients with OM (≤5 metastases) treated with SBRT between 2006 and 2017 was analyzed. Conditional overall survival (OS) and progression-free survival (PFS) in 3 years were obtained at multiple time points for all patients and by primary cancer type. Cox regression was used to determine trends in conditional OS and PFS. Changes in the predictors of OS and PFS over time were also determined by multivariable Cox regression. Results: The median follow-up was 24 months (0.3-105 months). Three-year OS and PFS at baseline were 56.7% and 23.2%, respectively. The OS in 3 years conditional on having survived for 3, 6, 12, and 24 months did not significantly change over time (56.7%, 55.4%, 55.8%, and 50.6%, respectively; P =.60). In contrast, the probability of PFS in 3 years conditional on having survived progression-free for 3, 6, 12, and 24 months significantly increased over time (23.6%, 27.3%, 35.1%, and 48.8%, respectively; P <.001). When stratified by primary site, conditional PFS significantly increased over time for patients with colorectal, breast, or kidney cancer. Conditional OS remained stable for patients with non-small cell lung cancer or kidney cancer but significantly decreased over time for patients with prostate, breast, or colorectal cancer. Changes in significant prognostic factors of OS and PFS over time were also observed. Conclusions: Analysis of conditional survival among patients with OM showed that as patients survived longer, their prognosis for further survival remained stable or decreased. However, patients who survived longer without disease progression had increased probability of PFS over time.
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U2 - 10.1016/j.ijrobp.2022.06.073
DO - 10.1016/j.ijrobp.2022.06.073
M3 - Article
C2 - 35753554
AN - SCOPUS:85137553595
SN - 0360-3016
VL - 114
SP - 902
EP - 909
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 5
ER -