Clinical and Translational Radiation Oncology (Mar 2023)
A predictive model of polymetastatic disease from a multicenter large retrospectIve database on colorectal lung metastases treated with stereotactic ablative radiotherapy: The RED LaIT-SABR study
- Luca Nicosia,
- Davide Franceschini,
- Francesca Perrone-Congedi,
- Alessandro Molinari,
- Marianna Alessandra Gerardi,
- Michele Rigo,
- Rosario Mazzola,
- Marco Perna,
- Vieri Scotti,
- Andrei Fodor,
- Aurelia Iurato,
- Francesco Pasqualetti,
- Giovanni Gadducci,
- Silvia Chiesa,
- Rita Marina Niespolo,
- Alessio Bruni,
- Anna Cappelli,
- Elisa D'Angelo,
- Paolo Borghetti,
- Alessandro Di Marzo,
- Andrea Ravasio,
- Berardino De Bari,
- Matteo Sepulcri,
- Dario Aiello,
- Gianluca Mortellaro,
- Claudia Sangalli,
- Marzia Franceschini,
- Giampaolo Montesi,
- Francesco Maria Aquilanti,
- Gianluigi Lunardi,
- Riccardo Valdagni,
- Ivan Fazio,
- Giovanni Scarzello,
- Vittorio Vavassori,
- Ernesto Maranzano,
- Stefano Maria Magrini,
- Stefano Arcangeli,
- Maria Antonietta Gambacorta,
- Vincenzo Valentini,
- Fabiola Paiar,
- Sara Ramella,
- Nadia Gisella Di Muzio,
- Mauro Loi,
- Barbara Alicja Jereczek-Fossa,
- Franco Casamassima,
- Mattia Falchetto Osti,
- Marta Scorsetti,
- Filippo Alongi
Affiliations
- Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy; Corresponding author at: Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, via Don Sempreboni 5, 37034 Verona, Negrar, Italy.
- Davide Franceschini
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy
- Francesca Perrone-Congedi
- Department of Radiation Oncology, “Sapienza” University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
- Alessandro Molinari
- Radioterapia Istituto Ricerche Cliniche Ecomedica, Empoli, Italy
- Marianna Alessandra Gerardi
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy
- Michele Rigo
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
- Rosario Mazzola
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy
- Marco Perna
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
- Vieri Scotti
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
- Andrei Fodor
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Aurelia Iurato
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128 Rome, Italy
- Francesco Pasqualetti
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy; Department of Oncology, University of Oxford, Oxford, UK
- Giovanni Gadducci
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
- Silvia Chiesa
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Rita Marina Niespolo
- Department of Radiation Oncology, University of Milan Bicocca, Italy
- Alessio Bruni
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
- Anna Cappelli
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
- Elisa D'Angelo
- Radiotherapy Unit, University Hospital of Modena, Modena, Italy
- Paolo Borghetti
- Radiation Oncology Department, ASST Spedali Civili di Brescia – Brescia University, Brescia, Italy
- Alessandro Di Marzo
- Radiation Oncology Centre, S. Maria Hospital, Terni, Italy
- Andrea Ravasio
- Radiotherapy Unit, Humanitas Gavazzeni, Bergamo, Italy
- Berardino De Bari
- Radiation Oncology Department, Neuchâtel Hospital Network, la Chaux-de-Fonds, Switzerland
- Matteo Sepulcri
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Dario Aiello
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
- Gianluca Mortellaro
- Department of Radiation Oncology, ARNAS Ospedale Civico, Palermo, Italy
- Claudia Sangalli
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Marzia Franceschini
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Giampaolo Montesi
- Radiotherapy Unit ULSS5, Rovigo, Italy
- Francesco Maria Aquilanti
- Radiotherapy Marrelli Hospital, Marrelli Hospital, Crotone, Italy
- Gianluigi Lunardi
- Clinical Analysis Laboratory and Transfusional Medicine, IRCCS Sacro Cuore Don Calabria, Negrar di Valpolicella, Italy
- Riccardo Valdagni
- Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
- Ivan Fazio
- Radiotherapy Unit, Casa di Cura Macchiarella, Palermo, Italy
- Giovanni Scarzello
- Radiation Oncology Unit, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
- Vittorio Vavassori
- Radiotherapy Unit, Humanitas Gavazzeni, Bergamo, Italy
- Ernesto Maranzano
- Radiation Oncology Centre, S. Maria Hospital, Terni, Italy
- Stefano Maria Magrini
- Radiation Oncology Department, ASST Spedali Civili di Brescia – Brescia University, Brescia, Italy
- Stefano Arcangeli
- Department of Radiation Oncology, University of Milan Bicocca, Italy
- Maria Antonietta Gambacorta
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
- Vincenzo Valentini
- UOC di Radioterapia Oncologica, Dipartimento Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy
- Fabiola Paiar
- Radiation Oncology Unit, Pisa University Hospital, Via Roma 67, 56123 Pisa, Italy
- Sara Ramella
- Radiation Oncology, Campus Bio-Medico University, Via A. del Portillo, 21, 00128 Rome, Italy
- Nadia Gisella Di Muzio
- Department of Radiation Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
- Mauro Loi
- Radiation Oncology Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
- Barbara Alicja Jereczek-Fossa
- Division of Radiation Oncology, IEO European Institute of Oncology IRCCS, Milan, Italy; Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
- Franco Casamassima
- Radioterapia Istituto Ricerche Cliniche Ecomedica, Empoli, Italy
- Mattia Falchetto Osti
- Department of Radiation Oncology, “Sapienza” University, Sant'Andrea Hospital, Via di Grottarossa 1035-1039, 00189 Rome, Italy
- Marta Scorsetti
- Department of Radiotherapy and Radiosurgery, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University Pieve Emanuele – Milan, Italy
- Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Cancer Care Center, Italy; University of Brescia, Brescia, Italy
- Journal volume & issue
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Vol. 39
p. 100568
Abstract
Aim: Stereotactic ablative radiotherapy (SABR) showed increasing survival in oligometastatic patients. Few studies actually depicted oligometastatic disease (OMD) evolution and which patient will remain disease-free and which will rapidly develop a polymetastatic disease (PMD) after SABR. Therefore, apart from the number of active metastases, there are no clues on which proven factor should be considered for prescribing local treatment in OMD. The study aims to identify predictive factors of polymetastatic evolution in lung oligometastatic colorectal cancer patients. Methods: This international Ethical Committee approved trial (Prot. Negrar 2019-ZT) involved 23 Centers and 450 lung oligometastatic patients. Primary end-point was time to the polymetastatic conversion (tPMC). Additionally, oligometastases number and cumulative gross tumor volume (cumGTV) were used as combined predictive factors of tPMC. Oligometastases number was stratified as 1, 2–3, and 4–5; cumGTV was dichotomized to the value of 10 cc. Results: The median tPMC in the overall population was 26 months. Population was classified in the following tPMC risk classes: low-risk (1–3 oligometastases and cumGTV ≤ 10 cc) with median tPMC of 35.1 months; intermediate-risk (1–3 oligometastases and cumGTV > 10 cc), with median tPMC of 13.9 months, and high-risk (4–5 oligometastases, any cumGTV) with median tPMC of 9.4 months (p = 0.000). Conclusion: The present study identified predictive factors of polymetastatic evolution after SABR in lung oligometastatic colorectal cancer. The results demonstrated that the sole metastases number is not sufficient to define the OMD since patients defined oligometastatic from a numerical point of view might rapidly progress to PMD when the cumulative tumor volume is high. A tailored approach in SABR prescription should be pursued considering the expected disease evolution after SABR, with the aim to avoid unnecessary treatment and toxicity in those at high risk of polymetastatic spread, and maximize local treatment in those with a favorable disease evolution.
