Impact of clinical target volume utilization on outcomes in patients with non-spine bone oligometastases treated with stereotactic ablative radiation therapy

IF 4.9 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-05-21 DOI:10.1016/j.radonc.2025.110948

Emily O’Reilly , Eshawn Johal , Haley Clark , Benjamin Mou , Reno Eufemon Cereno , Mitchell Liu , Devin Schellenberg , Will Jiang , Tanya Berrang , Abraham Alexander , Hannah Carolan , Siavash Atrchian , Emma M. Dunne , Scott Tyldesley , Robert Olson , Sarah Baker

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Abstract

Purpose

To compare local failure, marginal failure, and toxicity in non-spine bone metastases (NSBMs) treated with versus without a CTV for stereotactic ablative radiotherapy (SABR).

Methods

The study included all patients in British Columbia treated with SABR for NSBMs on the SABR-5 trial (November 2016 – July 2020) and on the BC Oligometastases Registry (August 2020- October 2022). NSBMs were stratified based on CTV use for treatment planning.

Results

148 patients with 183 NSBMs were included. 145 (79 %) NSBMs were treated with a CTV. Most lesions received 35 Gy in 5 fractions (80 %) or 24 Gy in 2 fractions (15 %). Local failure rates did not differ, with a 2-year local failure of 8.6 % (95 % confidence interval [CI] 3.9–13.2) with a CTV and 8.1 % (95 % CI 0–16.8) without a CTV (p = 0.53). Marginal failure did not differ (6.4 % [95 % CI 2.3–10.5] and 2.6 %, [95 % CI 0–7.7], respectively [p = 0.23]). 2-year cumulative incidence of grade ≥ 2 toxicity did not differ (15.8 %, 95 % CI 9.7–21.9 and 16.2 %, 95 % CI 4.2–28.2 respectively; p = 1.00). On multivariable regression, use of a CTV was not associated with the risk of local-marginal failure (hazard ratio [HR] 1.81, 95 % CI 0.62–5.31, p = 0.28). Extraosseous extension (HR 2.59, 95 % CI 1.2–5.7, p = 0.02) and lack of receipt of systemic therapy (HR 0.27, 95 % CI 0.1–0.5, p = 0.0002) were associated with higher risk.

Conclusions

Use of a CTV was not associated with local or marginal failure or toxicity. Extraosseous extension and lack of receipt of systemic therapy were associated with higher risk of local-marginal failure.

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临床靶体积利用对接受立体定向消融放疗的非脊柱骨少转移患者预后的影响。

目的：比较非脊柱骨转移瘤（NSBMs）在立体定向消融放疗（SABR）中使用CTV和不使用CTV治疗的局部失败、边缘失败和毒性。方法：该研究包括XXX试验（2016年11月至2020年7月）和XXX寡转移瘤注册（2020年8月至2022年10月）中接受SABR治疗的所有nsbm患者。根据CTV的使用情况对NSBMs进行分层，以制定治疗计划。结果：纳入148例183例NSBMs患者。145例（79 %）NSBMs接受CTV治疗。大多数病变接受35 Gy分5次（80 %）或24 Gy分2次（15 %）。局部失败率没有差异，有CTV的2年局部失败率为8.6 %(95 %可信区间[CI] 3.9-13.2)，没有CTV的2年局部失败率为8.1 %(95 % CI 0-16.8) （p = 0.53）。边际失败率无差异（分别为6.4 %[95 % CI 2.3-10.5]和2.6 %,[95 % CI 0-7.7] [p = 0.23]）。 ≥ 2级毒性的2年累积发生率无差异（15.8 %,95 % CI 9.7-21.9和16.2 %,95 % CI 4.2-28.2）； = 1.00页)。在多变量回归中，CTV的使用与局部边缘衰竭的风险无关（风险比[HR] 1.81, 95 % CI 0.62-5.31, p = 0.28）。骨外延伸（HR 2.59, 95 % CI 1.2-5.7, p = 0.02）和未接受全身治疗（HR 0.27, 95 % CI 0.1-0.5, p = 0.0002）与较高的风险相关。结论：CTV的使用与局部或边缘衰竭或毒性无关。骨外延伸和缺乏接受全身治疗与局部边缘衰竭的高风险相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.