Background/Objectives: Inadequate dosing and respiratory motion contribute to local recurrence for oligometastatic disease (OMD). While short-term LC rates are well-documented, data on long-term LC remain limited. This study investigated long-term LC after stereotactic body radiotherapy (SBRT), using respiratory motion management techniques.Methods:This retrospective study took place at UZ Brussel with follow-up until Oct 2024. It analyzed oligometastatic patients treated with SBRT between Jul 2012 and Feb 2017. Treatment involved delivering 50 Gy in 10 fractions on the 80% isodose line, building on data from a prior prospective study. Lesion movement was managed using internal target volume (ITV) or dynamic tumor tracking (DTT) with marker. The primary endpoint of the study was long-term LC and identifying variables associated with it using a Cox proportional hazards model.Results: A total of 100 patients were treated for a total of 211 metastatic lesions. Lesions were predominantly in the lungs (74%) and treated using ITV (88%). LC rates at 1, 3, 5, and 10 years were 76.5%, 53.8%, 38.1%, and 36.3%, respectively. Improved LC was observed in locations other than lung and liver (HR: 0.309;p= 0.024) and with increasing age (HR: 0.975;p< 0.010). Worse LC was seen in liver lesions (HR: 1.808;p= 0.103) and systemic therapy post-radiotherapy (HR: 3.726;p< 0.001). No significant associations were found with tumor size or tumor motion, nor between the two motion management strategies used (DTT and ITV).Conclusions: Appropriate motion management is key in LC for OMD. No significant difference in LC was found between both techniques. Lesion location, patient age, and systemic therapy post-radiotherapy were prognostic factors for LC.
背景/目的：剂量不足和呼吸运动是导致寡转移性疾病局部复发的原因。虽然短期局部控制率已有充分记录，但长期局部控制数据仍有限。本研究探讨了采用呼吸运动管理技术的立体定向体部放疗后的长期局部控制情况。方法：这项回顾性研究在布鲁塞尔大学医院进行，随访至2024年10月。研究分析了2012年7月至2017年2月期间接受SBRT治疗的寡转移患者。治疗方案基于先前前瞻性研究数据，在80%等剂量线上分10次给予50 Gy照射。病灶运动通过内靶区或带标记物的动态肿瘤追踪技术进行管理。研究主要终点是长期局部控制率，并使用Cox比例风险模型识别相关变量。结果：共100例患者接受了211个转移病灶的治疗。病灶主要位于肺部（74%），其中88%采用ITV技术管理。1年、3年、5年和10年的局部控制率分别为76.5%、53.8%、38.1%和36.3%。非肺肝部位病灶（HR：0.309；p=0.024）和年龄增长（HR：0.975；p<0.010）与更好的局部控制相关。肝脏病灶（HR：1.808；p=0.103）和放疗后全身治疗（HR：3.726；p<0.001）则与较差的局部控制相关。肿瘤大小、肿瘤运动幅度以及两种运动管理技术（DTT与ITV）之间均未发现显著相关性。结论：恰当的运动管理是寡转移疾病局部控制的关键。两种技术间的局部控制率无显著差异。病灶部位、患者年龄及放疗后全身治疗是局部控制的预后因素。
肿瘤(癌症)患者之家