Treatment of oligometastatic non-small cell lung cancer with radiotherapy – single-centre experience

Introduction:
Lung cancer is one of the most common malignancies in the world. Many attempts have been made to increase survival of this devastating disease, including the addition of local therapies in oligometastatic non-small cell lung cancer (OMD NSCLC). Oligometastatic disease is an intermediate state between a local and widely disseminated disease. The aim of the study was to assess the efficacy of stereotactic radiation therapy (SRT) in treatment of OMD NSCLC and to evaluate prognostic factors for survival.

Material and methods:
Medical records of 127 consecutive patients with OMD NSCLC who underwent SRT in University Clinical Centre in Gdańsk, Poland between 2016 and 2022 were obtained and clinical data were analysed for toxicity and efficacy.

Results:
There were 64.6% of patients with adenocarcinoma, 25.2% with squamous-cell carcinoma and 10.2% with other histological subtypes. Mean age was 66.9 years. Treatment was well tolerated in the majority of patients. Median progression-free survival (PFS) for synchronous OMD (sOMD) and metachronous OMD (mOMD) was 11.1 months and 14.4 months, respectively (p = 0.61). Median PFS for oligoprogression was 5.43 months. Median overall survival for sOMD and mOMD was 24.5 months and 36.8 months, respectively (p = 0.11). The most important prognostic factors were the number of metastases and performance status.

Conclusions:
Radical treatment in OMD NSCLC should be judicious and reserved for selected patients. Stereotactic radiation therapy is an important tool in the management of OMD NSCLC.