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Aggressive Local Ablative Radiotherapy Mitigates Progression Risk in Oligometastatic Lung Adenocarcinoma

 Gowoon Yang  ;  Kyung Hwan Kim  ;  Chang Geol Lee  ;  Min Hee Hong  ;  Hye Ryun Kim  ;  Yeona Cho  ;  Hong In Yoon 
 CANCER RESEARCH AND TREATMENT, Vol.56(1) : 115-124, 2024-01 
Journal Title
Issue Date
Adenocarcinoma of Lung* / radiotherapy ; Humans ; Lung Neoplasms* / pathology ; Progression-Free Survival ; Protein Kinase Inhibitors / therapeutic use ; Retrospective Studies
Adenocarcinoma ; Lung neoplasms ; Progression-free survival ; Radiosurgery
Purpose: This study aimed to determine the role of local ablative radiotherapy (LART) in oligometastatic/oligoprogressive lung adenocarcinoma.

Materials and methods: Patients (n=176) with oligometastatic lung adenocarcinoma treated with LART were identified, and those treated with LART at the initial diagnosis of synchronous oligometastatic disease (OMD group) or treated with LART when they presented with repeat oligoprogression (OPD group) were included.

Results: In the OMD group (n=54), the 1- and 3-year progression-free survival (PFS) were 50.9% and 22.5%, respectively, whereas the 1- and 3-year overall survival in the OPD group were 75.9% and 58.1%, respectively. Forty-one patients (75.9%) received LART at all gross disease sites. Tyrosine kinase inhibitor (TKI) use and all-metastatic site LART were significant predictors of higher PFS (p=0.018 and p=0.046, respectively). In patients treated with TKIs at the time of LART (n=23) and those treated with all-metastatic site LART, the 1-year PFS was 86.7%, while that of patients not treated with all-metastatic site LART was 37.5% (p=0.006). In the OPD group (n=122), 67.2% of the patients (n=82) maintained a systemic therapy regimen after LART. The cumulative incidence of changing systemic therapy was 39.6%, 62.9%, and 78.5% at 6 months, 1 year, and 2 years after LART, respectively.

Conclusion: Aggressive LART can be an option to improve survival in patients with oligometastatic disease. Patients with synchronous oligometastatic disease receiving TKI and all-metastatic site LART may have improved PFS. In patients with repeat oligoprogression, LART might potentially extend survival by delaying the need to change the systemic treatment regimen.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Hwan(김경환)
Kim, Hye Ryun(김혜련) ORCID logo https://orcid.org/0000-0002-1842-9070
Yang, Gowoon(양고운)
Yoon, Hong In(윤홍인) ORCID logo https://orcid.org/0000-0002-2106-6856
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Yeona(조연아) ORCID logo https://orcid.org/0000-0002-1202-0880
Hong, Min Hee(홍민희) ORCID logo https://orcid.org/0000-0003-3490-2195
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