Is there role for radiation treatment as a therapy for lung cancer with a limited number of metastases?

The authors aimed to evaluate the use of stereotactic body radiotherapy (SBRT) in patients with oligometastatic lung cancer. 

Oligometastatic lung cancer refers to a tumors that have only spread to a limited number of sites in the body.

Stereotactic body radiotherapy (or SBRT) involves the delivery of high dose radiation treatment at precise locations in the body, in order to destroy the original tumor or metastases (secondary tumors originating from the initial cancer site). SBRT can treat a limited number of tumors (such as in oligometastatic disease).

The authors aimed to evaluate the use of SBRT in oligometastatic lung cancer patiens. Patients had previously received a variety of treatments such as surgery, radiotherapy, chemotherapy or targeted anti-cancer drugs (which target specific weaknesses in tumor cells). 9 patients received SBRT alone and 17 patients received chemotherapy to reduce the size of their tumors prior to SBRT. The average follow up was 16.4 months.

At the time of analysis, 27% of patients had not developed disease recurrence. Cancer recurrence was seen in 16% of patients near the original tumor site, in 32% of patients at distant sites and in 52% of patients at both original and distant sites. The average time before the disease progressed following treatment was 11.2 months.

The average overall survival was 23 months and 67% of patients experienced survival at 1-year. Chemotherapy to reduce the size of the tumor prior to SBRT was associated with better rates of overall survival.  

Moderate toxicity was seen in 15% of patients including labored breathing, discomfort or difficulty while swallowing and inflammation in the lungs. 8% of patients experienced severe toxicity.

The authors concluded that SBRT was feasible in treating patients with oligometastatic lung cancer.

Larger studies are needed in order to better define the role of SBRT in the management of oligometastatic lung cancer.