Alicia Román-Jobacho, María Hernández-Miguel, María Jesús García-Anaya, Jaime Gómez-Millán, JA Medina-Carmona, Ana Otero-Romero*
Román-Jabacho et al. J Clin Transl Res 2021; 7(3):7
Published online: May 27, 2021
Abstract
Background: In the last decade major developments have improved the survival of patients with oligometastatic non-small cell lung cancer (OM-NSCLC). Between 20% and 50% of patients with NSCLC present oligometastases at diagnosis. For this group of patients, it seems that an increase in survival would justify aggressive local therapies. The development of minimally invasive surgery and advanced radiotherapy techniques like stereotactic body radiation therapy (SBRT) make local control possible for selected patients with metastatic NSCLC. The advantage of SBRT over surgery is that it is a non-invasive technique, with minimum side-effects, and is more suitable for fragile and elderly patients, non-candidates for surgery, or patients who refuse surgery.
Aim: The purpose of this review is to summarize the latest scientific evidence on the management of oligometastatic NSCLC, focusing on the role of radiotherapy.
Relevance for patients: The initial treatment recommended for patients with oligometastatic NSCLC is systemic therapy. Patients should be considered for radical treatment to both the primary tumor and oligometastases. Aggressive local therapy comprises surgery and/or definitive radiotherapy such as SRS or SBRT, and may be preceded or followed by systemic treatment. Recent clinical evidence from phase II trials reports benefits in terms of PFS in patients with good performance status and long disease-free periods, with good response to systemic therapy, especially in EGFR wild-type tumors. Phase I and II trials have shown that radiotherapy combined with immunotherapy can improve tumor response rate and possibly overall survival. The recommendation is also to include OM patients in ongoing clinical trials.
DOI: http://dx.doi.org/10.18053/jctres.07.202103.007
Author affiliation
1. Hospital Virgen de la Victoria. Málaga
2. Hospital Rey Juan Carlos. Móstoles, Madrid
*Corresponding author
Ana Otero-Romero
Department of Radiation Oncology, Hospital Virgen de la Victoria. Campus Teatinos s/n. 29010 Málaga. Spain.
Tel: +34 951032617
Email: ana_otero78@hotmail.com
Handling editor:
Michal Heger
Department of Pharmaceutics, Utrecht University, the Netherlands
Department of Pharmaceutics, Jiaxing University Medical College, Zhejiang, China
Downloads
Full text PDF
Review process file (143.6 KB)
