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Radiation Oncology/Palliation/Lung metastases

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< Radiation Oncology | Palliation
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Lung Metastases

  • TROG 13.01 SAFRON II (2015 - 2018) -- Single vs Multifraction SABR
    • Randomized. Phase II. 13 institutions in AUS/NZ. 90 patients, 113 oligometastases to lung. Eligible if 1-3 oligomets, >2 cm from central structures, tumor size <5 cm. No systemic therapy +/- 3 weeks of SABR. Arm 1) 28/1 Gy vs Arm 2) 48/3 Gy daily
    • 2023 PMID 37179526 -- "Long-Term Outcomes of TROG 13.01 SAFRON II Randomized Trial of Single- Versus Multifraction Stereotactic Ablative Body Radiotherapy for Pulmonary Oligometastases" (Siva, J Clin Oncol. 2023 Jul 1;41(19):3493-3498. doi: 10.1200/JCO.23.00150. Epub 2023 May 14.). Median F/U 5.4 years
      • Outcome: 3-year pool OS 70% and 4-year pooled OS 51%, no difference by arm (HR 1.1). No difference in DFS. Further local therapy in 91% patients. First relapse was extra-thoracic in 28%
      • Conclusion: Single fraction clinically effective, and more cost-effective
  • Colorado; 2009 PMID 19255320 -- "Multi-institutional phase I/II trial of stereotactic body radiation therapy for lung metastases." (Rusthoven KE, J Clin Oncol. 2009 Apr 1;27(10):1579-84. Epub 2009 Mar 2.)
    • Phase I/II. 38 patients, 63 lesions, 1-3 lesions. 71% prior chemo. Median GTV 4.2 ml (0.2-52.3 ml). SBRT 60/3 @ 20 Gy/fx. Median F/U 15 months
    • Outcome: Actuarial LC 1-year 100%, 2-years 96%. Median OS 19 months
    • Toxicity: Grade 3 toxicity 8% (3/38), symptomatic pneumonitis 3% (1/38)
    • Conclusion: High-dose SBRT safe and effective
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