Page 56 - ARNM-2-4

Advances in Radiotherapy
& Nuclear Medicine Efficacy of stereotactic radiotherapy

lung oligometastases (n = 23), no patient achieved CR, but not be determined. The 6-month and 1-year OS rates were
9 (39.13%) patients had PR, 10 (43.48%) patients exhibited 94.74% and 76.32%, respectively, with corresponding PFS
SD, and 4 (17.39%) patients showed PD, resulting in an rates of 86.84% and 63.16%.
ORR of 39.13% and DCR of 82.61%. For patients with brain Among the 35 patients with brain metastases, 1 (2.86%)
oligometastases (n = 35), 3 (8.57%) patients achieved CR, patient exhibited PD, and 16 (45.71%) patients died. The
22 (62.86%) patients had PR, 9 (25.71%) patients exhibited median OS was 17 months, and the median PFS was
SD, and 1 (2.86%) patient showed PD. The ORR and DCR 13 months. The 6-month and 1-year OS rates were 91.43%
were 71.43% and 97.14%, respectively (Table 2). and 60%, respectively, whereas the corresponding PFS
3.3. Survival outcomes rates were 80.00% and 48.57% (Table 3).
The median follow-up time for all patients, as of September 3.4. Adverse events
30, 2023, was 14 (range, 3 – 47) months. The median OS The most common adverse events were gastrointestinal
was 27 (range, 3 – 47) months, and the median PFS was 18 issues and myelosuppression. Anemia was the most
(range, 3 – 47) months (Figure 2).
frequent adverse event, occurring in 23 (23.96%) patients,
Among the 23 patients with lung oligometastases, PD with 21 (21.88%) cases classified as grades 1 – 2. Leukopenia
occurred in 4 (17.39%) patients, and 11 (47.83%) patients was the second most common frequent adverse event,
died. Both the median OS and PFS for this group were affecting 14 (14.58%) patients, with 13 (13.54%) cases
16 months. The 6-month and 1-year OS rates were 78.26% classified as grades 1 – 2. Additional adverse events
and 39.13%, respectively, whereas the corresponding PFS included thrombocytopenia, elevated bilirubin, increased
rates were 73.91% and 26.09%, respectively. aminotransferase levels, and gastrointestinal symptoms.
Among the 38 patients with liver metastases, 1 (2.63%) Severe adverse events (grade 3) were rare, with 2 cases
patient exhibited PD, and 17 (44.74%) patients died. The (2.08%) each of anemia and thrombocytopenia and
median OS was 33 months, whereas the median PFS could 1 (1.04%) case of leukopenia. Importantly, no grade 4
adverse events occurred (Table 4). Symptomatic treatments
effectively alleviated these adverse reactions.

4. Discussion
Malignant tumors often experience recurrence and
metastasis, leading to poor outcomes, especially when
systematic treatment alone is used. 16-18 Although
therapeutic strategies for metastatic tumors have
expanded, issues such as drug resistance and adverse
effects persist despite advancements in targeted therapies
and immunotherapy. 19-22 Surgical resection has shown
survival benefits in patients with oligometastatic non-
small cell lung cancer and brain metastases without lymph
node involvement. 23,24 Approximately 50% of patients
Figure 1. Tumor response following treatment
Abbreviations: CR: Complete response; PR: Partial response; with colorectal cancer present with liver metastases at
PD: Progressive disease; SD: Stable disease. diagnosis, and surgical resection remains the gold standard

Table 2. Efficacy evaluation at 3 months after stereotactic radiotherapy
Oligometastasis Liver (%) Lung (%) Brain (%) Total (%)
CR 10 (26.32) 0 (0.00) 3 (8.57) 13 (13.54)
PR 19 (50.00) 9 (39.13) 22 (62.86) 50 (52.08)
SD 8 (21.05) 10 (43.48) 9 (25.71) 27 (28.13)
PD 1 (2.63) 4 (17.39) 1 (2.86) 6 (6.25)
ORR 76.32 39.13 71.43 65.62
DCR 97.37 82.61 97.14 93.75
Abbreviations: CR: Complete response; DCR: Disease control rate; ORR: Objective response rate; PD: Progressive disease; PR: Partial response;
SD: Stable disease.

Volume 2 Issue 4 (2024) 4 doi: 10.36922/arnm.3391